Summary & Overview
CPT 90376: Rabies Immunoglobulin (Human) for Post-Exposure Prophylaxis
CPT code 90376 represents rabies immunoglobulin derived from pooled human plasma, used to provide passive immunity for category III rabies exposures. This code is critical for billing administration of biologic immune globulin in post‑exposure prophylaxis and acute management, as timely administration can prevent fatal rabies infection.
Key national payers typically involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements can affect access and site‑of‑care decisions across hospital, emergency department, urgent care, and ambulatory infusion settings.
Readers will find a concise overview of the clinical context and coding purpose, payer coverage landscape, and the types of operational benchmarks and policy considerations that commonly accompany high‑cost, time‑sensitive biologic therapies. The publication summarizes clinical indications tied to the code, typical sites of service where 90376 is billed, common billing modifiers (listed separately), and guidance on where input data is not available. This national summary is designed to inform coding staff, revenue cycle managers, and clinical leaders about the role of CPT code 90376 in post‑exposure rabies care and billing workflows.
Billing Code Overview
CPT code 90376 describes rabies immunoglobulin (human), a preparation of pooled human gamma globulin with high titers of antibodies to the rabies virus used to provide passive immunity. These products are used for post‑exposure prophylaxis and treatment of category III rabies exposures to neutralize virus at the wound site and provide immediate antibody protection.
Service type: Passive immunotherapy / biologic blood product administration
Typical site of service: Hospital inpatient or outpatient settings, emergency departments, urgent care clinics, and ambulatory infusion centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a previously unvaccinated adult or child presenting after a high‑risk animal bite or other exposure consistent with category III rabies exposure (transdermal bite, contamination of mucous membrane with saliva, or multiple severe bites). The patient arrives to the emergency department or urgent care clinic; triage documents the exposure mechanism, wound severity, and timing. The clinician assesses tetanus status, performs wound cleansing and closure as indicated, and determines rabies post‑exposure prophylaxis is required. Rabies immunoglobulin (90376) is calculated by weight (human rabies immunoglobulin), infiltrated around wounds when feasible, with any remaining volume administered intramuscularly at a distant site, and given once at initiation of post‑exposure prophylaxis together with rabies vaccine series. Typical sites of service are hospital emergency departments, urgent care centers, outpatient clinics with immunization capability, and public health clinics. The clinical workflow includes patient assessment, informed consent, weight‑based dose calculation, wound infiltration technique, documentation of lot and expiration numbers, observation for immediate adverse reaction, and scheduling of vaccine doses for completion of prophylaxis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard submission when no modifier applies |