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    v1.0.28
    OpenPayerBilling CodesImmune Globulins, Serum or Recombinant ProductsCPT cpt-90396-varicella-zoster-immune-globulin-immunoprophylaxis
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    CPT 90396: Intramuscular Varicella–Zoster Immune Globulin

    CPT code 90396 describes the supply of intramuscular human varicella–zoster immune globulin intended to provide passive immunity or boost protection against chickenpox; service type: immune globulin supply/injection, typical site of service: outpatient clinic, physician office, or other ambulatory setting where intramuscular administration is performed.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an immunocompromised adult or newborn with recent exposure to varicella (chickenpox) or a high-risk pregnant woman without evidence of varicella immunity. The patient presents to an outpatient infusion or immunization clinic, emergency department, or inpatient unit for evaluation of exposure and suitability for prophylaxis. The clinician documents the exposure history, immune status (history of varicella, vaccination records, or varicella IgG serology), and risk factors (e.g., hematologic malignancy, solid organ transplant, immunosuppressive therapy, pregnancy, neonate of a mother with peripartum varicella). When indicated, intramuscular human varicella–zoster immune globulin is ordered and administered as a single IM dose. The workflow includes informed consent, verification of product lot and expiration, medication preparation by pharmacy or trained nursing staff, administration with standard IM technique, and documentation of lot number, dose, site, and patient response. Billing uses 90396 for the supply of the immune globulin; the medical record links the administration to the qualifying exposure and relevant diagnosis code(s). Typical sites of service include outpatient clinics, emergency departments, hospital inpatient units, and specialty infusion centers.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    90460Immunization administration through 18 years of age via any route, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administeredUse when documentation requires a vaccine administration code for counseling and administration in pediatric patients receiving prophylactic immunoglobulin (if payer requires separate immunization administration coding)
    90461Each additional vaccine or toxoid component administered (List separately in addition to code for primary service)Use if multiple vaccine components are administered at the same visit alongside immune globulin and payer requests separate reporting
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularUse when payers require reporting an injection administration code in addition to the drug/supply code for 90396
    36415Collection of venous blood by venipunctureUse when pre-administration serology (varicella IgG) is performed contemporaneously to assess immunity
    96360Intravenous infusion, hydration; initial, 31 minutes to 1 hourUse if intravenous access and infusion-related services are provided for associated therapies in the same encounter
    99070Supplies and materials (except those usually included with the basic service), e.g., syringes, glovesUse to report non-covered additional supplies related to preparation and administration when allowed by payer

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    207WX0120XCornea and External Diseases Specialist PhysicianAn ophthalmologist who specializes in diseases of the cornea, sclera, eyelids, conjunctiva, and anterior segment of the eye.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    261QG0250XGenetics Clinic/CenterAn entity, facility, or distinct part of a facility providing analysis of family history, genetic laboratory testing and analysis, diagnosis of geneti…

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    B01.9Varicella without complication
    B02.9Zoster without complications
    C00.9Malignant neoplasm of lip, unspecified
    D70.9Neutropenia, unspecified
    D73.9Disease of spleen, unspecified
    D84.9Immunodeficiency, unspecified
    D89.9Disorder involving the immune mechanism, unspecified
    J12.9Viral pneumonia, unspecified
    J18.9Pneumonia, unspecified organism
    R50.9Fever, unspecified

    Showing 1–10 of 21

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    Related Codes

    CPT-90281-IMMUNOGLOBULIN-THERAPY-INFUSION

    CPT 90281: Immunoglobulin for Passive Immunity

    CPT-90283-IMMUNOGLOBULIN-PASSIVE-IMMUNITY

    CPT 90283: Immunoglobulin for Passive Immunity

    CPT-90284-SUBCUTANEOUS-IMMUNOGLOBULIN-INJECTION-SCIG-IGSC

    CPT 90284: Subcutaneous Immunoglobulin (SCIg) Injection

    CPT-90287-BOTULISM-ANTITOXIN-EQUINE-GLOBULIN

    CPT 90287: Botulism Antitoxin (Equine Globulin)

    CPT-90288-BOTULISM-IMMUNE-GLOBULIN-INTRAVENOUS

    CPT 90288: Botulism Immune Globulin Intravenous Administration

    CPT-90291-CMV-IMMUNE-GLOBULIN-INTRAVENOUS-INFUSION

    CPT 90291: Cytomegalovirus Immune Globulin (CMV–IgIV) Administration

    CPT-90296-DIPHTHERIA-ANTITOXIN-EQUINE

    CPT 90296: Diphtheria Antitoxin (Equine) Administration

    CPT-90371-HEPATITIS-B-IMMUNOGLOBULIN-HBIG

    CPT 90371: Hepatitis B Immunoglobulin (HBIg) Injection

    CPT-90375-RABIES-IMMUNOGLOBULIN-PASSIVE-IMMUNITY

    CPT 90375: Human Rabies Immunoglobulin for Passive Immunity

    CPT-90376-RABIES-IMMUNOGLOBULIN-HUMAN-POST-EXPOSURE-PROPHYLAXIS

    CPT 90376: Human Rabies Immunoglobulin for Passive Immunity

    Showing 1–10 of 21

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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