CPT® Code 90672

Official Description

Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use

Common Language Description

The CPT® Code 90672 refers to the quadrivalent live attenuated influenza virus vaccine (LAIV4) specifically designed for intranasal use. Vaccines, unlike immune globulins that offer short-term, passive immunity, provide active and long-lasting immunity. This is achieved by exposing the recipient's immune system to modified forms of specific viruses or bacteria, prompting the immune system to generate its own antibodies against these pathogens. The immune system retains a memory of how to produce these antibodies, enabling a quicker response upon subsequent exposures to the same antigens. The LAIV4 is a live attenuated vaccine, meaning it contains a weakened form of the live influenza virus. This quadrivalent formulation includes two strains of influenza A and two strains of influenza B, ensuring broader protection against circulating influenza viruses. Administered as a nasal spray, LAIV4 effectively stimulates the immune system to produce antibodies against the influenza virus. Notably, LAIV4 is cold-adapted and temperature-sensitive, allowing the virus to replicate only in the cooler environment of the nose and throat, thus preventing it from spreading to the upper respiratory tract where the body temperature is higher. It is important to note that this code specifically reports the vaccine product itself, and the administration of the vaccine via the intranasal route should be reported separately.

1. Indications

The quadrivalent live attenuated influenza virus vaccine (LAIV4) is indicated for the prevention of influenza in individuals who are eligible for vaccination. The vaccine is particularly recommended for the following groups:

Individuals aged 2 to 49 years who are not contraindicated for the use of live attenuated vaccines.
Individuals at risk of influenza-related complications including those with chronic medical conditions, pregnant women, and healthcare workers.

2. Procedure

The administration of the LAIV4 vaccine involves several key procedural steps to ensure effective delivery and immune response:

Step 1: Patient Assessment Prior to administration, the healthcare provider must assess the patient's medical history to confirm eligibility for the LAIV4 vaccine. This includes checking for any contraindications such as severe allergic reactions to vaccine components or a history of asthma in children under 5 years of age.
Step 2: Preparation of the Vaccine The LAIV4 vaccine is prepared according to the manufacturer's instructions. This typically involves removing the vaccine from refrigeration and allowing it to reach room temperature before administration to ensure optimal effectiveness.
Step 3: Administration of the Vaccine The vaccine is administered intranasally. The healthcare provider will position the patient comfortably and instruct them to tilt their head slightly back. The vaccine is then sprayed into one nostril while the patient inhales gently, allowing the vaccine to reach the nasal mucosa where it can stimulate an immune response.
Step 4: Post-Administration Observation After administration, the patient should be observed for a short period to monitor for any immediate adverse reactions. This is particularly important for individuals who have a history of allergies or previous reactions to vaccines.

3. Post-Procedure

Following the administration of the LAIV4 vaccine, patients are generally advised to avoid close contact with immunocompromised individuals for a short period. They may experience mild side effects such as nasal congestion, runny nose, or low-grade fever, which typically resolve on their own. It is important for patients to be informed about the signs of potential adverse reactions and when to seek medical attention. Additionally, patients should be encouraged to maintain regular health check-ups and follow-up vaccinations as recommended by healthcare guidelines.

Short Descr	LAIV4 VACCINE INTRANASAL
Medium Descr	LAIV4 VACCINE FOR INTRANASAL USE
Long Descr	Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use
Related Drugs	FluMist Quadrivalent
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
ASC Payment Indicator	Influenza vaccine; pneumococcal vaccine.
Type of Service (TOS)	V - Pneumococcal/Flu Vaccine
Berenson-Eggers TOS (BETOS)	O1G - Immunizations/Vaccinations
MUE	1
CCS Clinical Classification	228 - Prophylactic vaccinations and inoculations