Summary & Overview
CPT 90389: Tetanus Immunoglobulin for Passive Immunization
CPT code 90389 designates tetanus immunoglobulin (TIg), a human plasma–derived preparation used to provide passive immunity against tetanus. TIg is clinically important for post-exposure prophylaxis in patients with certain wounds or when active immunization is inadequate. Nationally, availability and appropriate use of TIg affect acute care pathways, emergency services, and hospital formularies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise review of clinical context, payer coverage considerations, and billing and service-line implications for institutions that administer TIg.
Readers will learn the clinical purpose of CPT code 90389, typical sites of service where TIg is administered, and the operational contexts relevant to billing and claims submission. The report includes benchmark and coverage summaries from major payers where available, notes on common modifiers associated with related immunoglobulin administration, and discussion of clinical scenarios prompting TIg use. Data not available in the input are identified as such and omitted from the sections that require them.
Billing Code Overview
CPT code 90389 represents tetanus immunoglobulin (TIg) derived from human plasma donors sensitized to tetanus toxin. TIg provides passive immunity and is used as a preventive agent against tetanus in patients at risk of exposure or with wounds where active immunization is insufficient or contraindicated.
Service Type: Immune globulin administration / passive immunization
Typical Site of Service: Hospital inpatient or outpatient settings, emergency department, wound care clinics, and other acute care settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 32-year-old unvaccinated adult presents to the emergency department after sustaining a deep puncture wound from a rusty nail while gardening. The wound occurred 12 hours prior; the patient has not received tetanus immunization within the last 10 years and reports uncertain prior immunization history. The ED clinician evaluates the wound, performs wound irrigation and tetanus-prone wound assessment, documents immunization history, and determines that passive immunization is indicated in addition to tetanus toxoid. Human tetanus immunoglobulin (TIg) is ordered and administered intramuscularly in the ED to provide immediate passive immunity while tetanus vaccine (tetanus toxoid-containing vaccine) is arranged for active immunization.
Typical workflow: triage and wound assessment → history and immunization review → wound cleaning and local care → indication documented for TIg → informed consent and medication administration → observation for immediate adverse reaction → documentation of lot number, dose, route, site, and consent. Usual sites of service include emergency department, urgent care, outpatient clinic with on-site immunization capability, and inpatient settings when required for wound management or tetanus risk factors.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard processing | Use when no special circumstances apply to the service. |