© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 90679 refers to a specific vaccine designed to provide active, long-term immunity against respiratory syncytial virus (RSV). This vaccine is a recombinant, subunit formulation that includes a stabilized version of the virus's prefusion F glycoprotein, known as RSVPreF3. This glycoprotein is crucial for the virus's ability to enter host cells, making it a key target for the immune response. By introducing this altered version of the virus into the body, the vaccine stimulates the immune system to produce antibodies that can recognize and combat RSV upon future exposure. RSV is a highly contagious virus that primarily affects infants and young children, but it can also pose significant risks to older adults, individuals with compromised immune systems, and those with underlying health conditions such as diabetes, congestive heart failure, asthma, or chronic obstructive pulmonary disease (COPD). Infections caused by RSV can lead to severe respiratory illnesses, including pneumonia, which may require hospitalization and can be fatal. The vaccine is administered intramuscularly and is particularly important for adults in higher risk categories, as it enhances their immune response through the use of a proprietary adjuvant. It is important to note that this code specifically reports the vaccine product itself and does not include the administration of the vaccine.
© Copyright 2025 Coding Ahead. All rights reserved.
The vaccine represented by CPT® Code 90679 is indicated for the prevention of respiratory syncytial virus (RSV) infection, particularly in populations at higher risk. The following conditions and demographics are explicitly noted as indications for the use of this vaccine:
The administration of the vaccine involves several key procedural steps that ensure its effectiveness and safety. The following steps outline the procedure for administering the RSV vaccine:
Following the administration of the RSV vaccine, patients are advised to remain in the healthcare setting for a brief observation period to monitor for any immediate adverse reactions, such as allergic responses. Common post-vaccination care includes advising patients about potential side effects, which may include mild pain or swelling at the injection site, low-grade fever, or fatigue. Patients should be informed to report any unusual or severe reactions to their healthcare provider. Additionally, it is important to document the administration details, including the date, site of injection, and any reactions observed during the monitoring period. Patients may also be provided with information on follow-up appointments or additional vaccinations if required.
| Short Descr | RSV VACC PREF RECOMB ADJT IM | Medium Descr | RSV VACC PREF RECOMBINANT ADJUVANTED FOR IM USE | Long Descr | Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use | Status Code | Non-Covered Service | 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 | Items and Services Not Billable to the MAC | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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 | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | HX | Funded by county/local agency | JZ | Zero drug amount discarded/not administered to any patient | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | SK | Member of high risk population (use only with codes for immunization) | SL | State supplied vaccine |
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| 2024-01-01 | Added | First appearance in CodeBook |
| 2023-05-03 | Added | Addition released to AMA website on 2023-05-05. FDA approval received and Retroactive to 2023-05-03. |
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