© Copyright 2025 American Medical Association. All rights reserved.
Pneumococcal bacteria are a significant cause of various serious infections, including pneumococcal pneumonia, bacteremia, and meningitis. To combat these infections, pneumococcal conjugate vaccines have been developed. These vaccines are formulated using the purified external layer of the bacteria's cell wall, which is then fused to a stronger antigen carrier molecule, specifically a nontoxic variant of diphtheria known as CRM197. The effectiveness of these vaccines is determined by the number of different serotypes of Streptococcus pneumoniae that they cover. The CPT® Code 90677 specifically refers to the pneumococcal conjugate vaccine that is 20 valent (PCV20), meaning it is designed to protect against 20 distinct serotypes of the bacteria. The serotypes included in this vaccine are 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F. This vaccine is intended for use in adults aged 18 and older, providing broad coverage against the primary serotypes that are responsible for invasive pneumococcal disease and pneumonia. It is important to note that the intramuscular administration of this vaccine is reported separately, ensuring accurate coding and billing for the procedure.
© Copyright 2025 Coding Ahead. All rights reserved.
The pneumococcal conjugate vaccine, 20 valent (PCV20), is indicated for use in adults aged 18 years and older. It is specifically recommended for the prevention of invasive pneumococcal disease, which includes conditions such as pneumococcal pneumonia, bacteremia, and meningitis caused by the Streptococcus pneumoniae bacteria. The vaccine is designed to provide broad protection against the main serotypes responsible for these serious infections.
The administration of the pneumococcal conjugate vaccine, 20 valent (PCV20), involves several key procedural steps to ensure proper delivery and effectiveness of the vaccine. First, the healthcare provider will prepare the vaccine for administration, which includes checking the vaccine's expiration date and ensuring that it has been stored correctly. Next, the provider will select an appropriate site for intramuscular injection, typically the deltoid muscle of the upper arm, as this site is recommended for adult vaccinations. The skin at the injection site will be cleaned with an antiseptic wipe to minimize the risk of infection. Following this, the provider will draw the vaccine into a syringe, ensuring that no air bubbles are present, and then will insert the needle into the muscle at a 90-degree angle. After the injection, the provider will withdraw the needle quickly and apply gentle pressure to the injection site with a cotton ball or gauze. Finally, the provider will dispose of the needle and syringe in a sharps container and document the administration of the vaccine in the patient's medical record, including the date, site of injection, and any relevant lot numbers.
After the administration of the pneumococcal conjugate vaccine, 20 valent (PCV20), patients are typically monitored for a short period to observe for any immediate adverse reactions, such as allergic responses. It is common for patients to experience mild side effects at the injection site, including pain, redness, or swelling. Systemic reactions may also occur, such as fever, fatigue, or headache, but these are generally mild and resolve within a few days. Patients are advised to rest and stay hydrated following the vaccination. It is important for healthcare providers to inform patients about the potential side effects and to provide guidance on when to seek medical attention if they experience severe or unusual symptoms. Additionally, documentation of the vaccine administration should be maintained in the patient's medical record for future reference and to ensure compliance with vaccination schedules.
| Short Descr | PCV20 VACCINE IM | Medium Descr | PCV20 VACCINE FOR INTRAMUSCULAR USE | Long Descr | Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | Related Drugs | Prevnar 20 | 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) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| GA | Waiver of liability statement issued as required by payer policy, individual case | JZ | Zero drug amount discarded/not administered to any patient | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | CR | Catastrophe/disaster related | 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. | SL | State supplied vaccine | 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 | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | U6 | Medicaid level of care 6, as defined by each state | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | A6 | Dressing for six wounds | AO | Alternate payment method declined by provider of service | CG | Policy criteria applied | FS | Split (or shared) evaluation and management visit | GE | This service has been performed by a resident without the presence of a teaching physician under the primary care exception | GT | Via interactive audio and video telecommunication systems | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GX | Notice of liability issued, voluntary under payer policy | HA | Child/adolescent program | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | SK | Member of high risk population (use only with codes for immunization) | U8 | Medicaid level of care 8, as defined by each state | UA | Medicaid level of care 10, as defined by each state | UC | Medicaid level of care 12, as defined by each state | UD | Medicaid level of care 13, as defined by each state | X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2022-01-01 | Added | First appearance in codebook. |
| 2021-07-01 | Added | Code added. |
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