Summary & Overview
CPT 90473: Live Attenuated Vaccine Administration, Intranasal or Oral
CPT code 90473 denotes the administration of a live attenuated vaccine by intranasal or oral route. This code captures non-injectable vaccine delivery performed by a provider and is relevant for tracking immunization services, ensuring correct billing, and aligning payer reimbursement with clinical practice. Live attenuated intranasal or oral vaccines play a role in preventive care and outbreak response, making accurate coding important for public health monitoring and practice revenue cycle management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, reimbursement benchmarks where available, and how CPT code 90473 fits into vaccine administration workflows across outpatient ambulatory settings.
Readers will learn the clinical and billing context for CPT code 90473, typical sites of service, common modifiers and coding considerations (overview), and where to find additional coding guidance. The summary highlights how the code is used in practice, lists data elements that are available, and notes when input data is not provided. Data not available in the input is explicitly identified in relevant sections of the full publication.
Billing Code Overview
CPT code 90473 represents administration of a live attenuated vaccine delivered via intranasal or oral route. The procedure involves the provider administering the vaccine to the patient using a non-injectable route.
Service type: Vaccine administration, live attenuated, intranasal or oral.
Typical site of service: Outpatient clinic, primary care office, urgent care, or other ambulatory settings where vaccinations are provided.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 3-year-old child presents to a pediatric clinic during influenza season for routine immunization. The child has no contraindications to live attenuated influenza vaccine and the provider administers the vaccine intranasally during a scheduled well-child visit. The clinical workflow includes verification of identity and vaccine history, screening for contraindications/allergies, informed consent from the parent, preparation of the intranasal dose, administration of the live attenuated vaccine to each nostril, documentation of lot number/expiration/manufacturer in the medical record and immunization registry, and observation for a brief post-vaccination period for adverse reactions. This procedure may also occur during community vaccination clinics at an ambulatory clinic or public health site when intranasal live attenuated vaccines are offered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | When a same-day E/M visit meets criteria in addition to the vaccine administration (e.g., acute visit with evaluation beyond routine vaccine counseling). |
59 | Distinct procedural service |