© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 90688 refers to a specific type of influenza virus vaccine known as the quadrivalent influenza vaccine (IIV4). This vaccine is designed to provide protection against four different strains of the influenza virus, specifically two strains of influenza type A and two strains of influenza type B. The term "quadrivalent" indicates that the vaccine targets multiple strains, enhancing its effectiveness in preventing influenza infections during the flu season. The vaccine is classified as a split virus vaccine, meaning that the virus particles have been chemically disrupted to create a form that is less likely to cause disease while still being able to stimulate an immune response. The dosage for this vaccine is 0.5 mL, and it is administered via intramuscular injection, which is a common method for delivering vaccines directly into the muscle tissue. This method allows for a more effective immune response compared to other routes of administration. It is important to note that the vaccine is produced using embryonated chicken eggs, where the virus is cultivated, harvested, and then inactivated with formaldehyde to ensure safety. The vaccine's formulation is crucial for inducing long-term immunity, as it prompts the immune system to recognize and remember the influenza virus, enabling the body to produce antibodies upon subsequent exposures. For billing purposes, it is essential to report the vaccine product separately from the administration of the intramuscular injection, with code 90688 specifically indicating the 0.5 mL dosage of the quadrivalent influenza vaccine.
© Copyright 2025 Coding Ahead. All rights reserved.
The quadrivalent influenza virus vaccine (IIV4) is indicated for the prevention of influenza disease caused by the four specific strains of the virus it targets. The vaccine is recommended for individuals who are at risk of contracting influenza, particularly during the flu season. The following conditions and populations may warrant the administration of this vaccine:
The administration of the quadrivalent influenza vaccine (IIV4) involves several key procedural steps to ensure proper delivery and effectiveness of the vaccine. The following steps outline the procedure:
Post-procedure care for the administration of the quadrivalent influenza vaccine (IIV4) includes monitoring the patient for any immediate adverse reactions, such as allergic responses or injection site reactions. Patients are typically advised to remain in the healthcare setting for a brief observation period following the injection. Common side effects may include soreness at the injection site, mild fever, or fatigue, which usually resolve within a few days. Patients should be educated on the importance of reporting any severe or unusual symptoms that may arise after vaccination. Additionally, it is essential to remind patients that the vaccine does not provide immediate immunity and that it may take up to two weeks for the body to develop a protective immune response. Follow-up appointments may be necessary for individuals requiring additional doses or for those who need to receive the vaccine annually.
| Short Descr | IIV4 VACCINE SPLT 0.5 ML IM | Medium Descr | IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE | Long Descr | Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use | Related Drugs | Afluria 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 |
| 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 | 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 | GW | Service not related to the hospice patient's terminal condition | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | JZ | Zero drug amount discarded/not administered to any patient | SL | State supplied vaccine | GC | This service has been performed in part by a resident under the direction of a teaching physician | UD | Medicaid level of care 13, as defined by each state | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 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. | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | 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 | 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 | SK | Member of high risk population (use only with codes for immunization) | U1 | Medicaid level of care 1, as defined by each state | U6 | Medicaid level of care 6, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | UC | Medicaid level of care 12, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2017-01-01 | Changed | Long, Medium and Short descriptions changed. |
| 2016-01-01 | Changed | First appearance of change in codebook. |
| 2015-07-01 | Changed | Description Changed |
| 2014-01-01 | Added | First appearance in codebook. |
| 2013-01-01 | Added | - |
Get instant expert-level medical coding assistance.