Summary & Overview
CPT 90287: Botulism Antitoxin, Equine-Derived Globulin
CPT code 90287 designates Botulism Antitoxin, an equine-derived, enzymatically modified globulin preparation used to neutralize circulating botulinum toxin. Nationally, this code represents a critical acute-care biologic with implications for emergency and inpatient treatment protocols, supply chain management, and payer coverage for high-cost, lifesaving therapies. Its use is episodic but clinically urgent, making accurate coding and timely authorization important for hospitals and emergency providers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the product, typical sites of service, payer coverage considerations, and benchmarking content where available. The publication outlines coding specifics for billing teams, outlines common modifiers and administrative notes provided in the input, and highlights gaps where data are not available.
This summary is intended for billing managers, hospital administrators, and clinicians involved in acute care delivery and revenue cycle operations who need a clear, national-level reference on CPT code 90287 and its role in botulism treatment.
Billing Code Overview
CPT code 90287 describes Botulism Antitoxin, a refined and concentrated liquid preparation of horse (equine) globulins that have been modified by enzymatic digestion. This product is used to neutralize circulating botulinum toxin in patients with suspected or confirmed botulism.
Service type: Antitoxin biologic administration / passive immunotherapy
Typical site of service: Hospital inpatient or emergency department where acute neutralization of toxin is required and intravenous administration and monitoring can be provided.
Clinical & Coding Specifications
Clinical Context
A typical scenario involves an emergency department or inpatient adult patient presenting with suspected botulism — progressive, symmetric cranial nerve palsies (diplopia, dysarthria, dysphagia), descending flaccid paralysis, and/or respiratory compromise after foodborne exposure, wound contamination, or injection drug use. After clinical suspicion is established by the emergency physician, neurologist, or infectious disease specialist, public health authorities and the treating team coordinate rapid procurement and administration of botulism antitoxin to neutralize circulating neurotoxin.
The clinical workflow commonly includes: initial triage and airway assessment; neurologic examination documenting cranial nerve and motor deficits; supportive measures (airway protection, mechanical ventilation if needed); notification of local or state public health for antitoxin release; informed consent discussion with the patient or surrogate; intravenous administration of the antitoxin in a monitored setting (ED, ICU, or inpatient ward) with readiness to manage hypersensitivity reactions; post-administration monitoring for allergic/anaphylactic events and ongoing supportive care including respiratory and nutritional management. Documentation should include time of symptom onset, neurologic findings, indication for antitoxin, lot number and dose of 90287 administered, consent, and any adverse reactions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |