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The CPT® Code 90671 refers to the pneumococcal conjugate vaccine, specifically the 15 valent formulation (PCV15), which is intended for intramuscular use. Vaccines, such as PCV15, play a crucial role in providing active and long-term immunity by introducing altered versions of specific pathogens, in this case, pneumococcal bacteria, to the recipient's immune system. This exposure prompts the immune system to produce antibodies that can recognize and combat the actual pathogens if encountered in the future. The pneumococcal bacteria can reside harmlessly in the nasal passages and throat; however, they pose a significant risk when they invade other parts of the body, potentially leading to serious conditions such as pneumococcal pneumonia, bacteremia, and meningitis. Certain populations, including young children, the elderly, and individuals with compromised immune systems, are particularly vulnerable to these infections. The pneumococcal conjugate vaccines are formulated using a purified component of the bacteria's cell wall, which is combined with a nontoxic variant of diphtheria (CRM197) to enhance the immune response. The vaccines are categorized based on the number of serotypes of Streptococcus pneumoniae they cover. For instance, the 13 valent pneumococcal conjugate vaccine (PCV13), represented by CPT® Code 90670, covers specific serotypes, while the 15 valent vaccine (PCV15), denoted by CPT® Code 90671, includes additional serotypes 22F and 33F, thereby offering broader protection against the most prevalent disease-causing strains globally. The administration of this vaccine is performed via an intramuscular injection, which is a separately reportable procedure in medical coding.
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The pneumococcal conjugate vaccine (PCV15) is indicated for use in various populations to prevent infections caused by pneumococcal bacteria. The following conditions and demographics are explicitly recognized for vaccination:
The administration of the pneumococcal conjugate vaccine (PCV15) involves several key procedural steps to ensure proper delivery and effectiveness:
Following the administration of the pneumococcal conjugate vaccine (PCV15), patients may experience mild side effects such as soreness at the injection site, low-grade fever, or fatigue. These reactions are generally short-lived and resolve without intervention. It is important for healthcare providers to advise patients on post-vaccination care, including the application of a cool compress to the injection site to alleviate discomfort. Patients should also be instructed to seek medical attention if they experience any severe or unusual reactions. Additionally, documentation of the vaccine administration, including the date, site, and any adverse reactions, is essential for maintaining accurate medical records and ensuring compliance with vaccination protocols.
| Short Descr | PCV15 VACCINE IM | Medium Descr | PCV15 VACCINE FOR INTRAMUSCULAR USE | Long Descr | Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use | Related Drugs | VAXNEUVANCE | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product | Type of Service (TOS) | V - Pneumococcal/Flu Vaccine | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CG | Policy criteria applied | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | JZ | Zero drug amount discarded/not administered to any patient | LT | Left side (used to identify procedures performed on the left side of the body) | SL | State supplied vaccine | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care |
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| 2022-01-01 | Added | First appearance in codebook. |
| 2021-07-01 | Added | Code added. |
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