CPT 90477: Live Oral Vaccine for Adenovirus Type 7 - OpenPayer

Summary & Overview

CPT 90477: Live Oral Vaccine for Adenovirus Type 7

CPT code 90477 represents administration of a live oral vaccine product for adenovirus type 7, used to prevent respiratory and related illnesses caused by this serotype. Nationally, vaccine administration codes like 90477 are important for tracking immunization delivery, public health response, and billing for preventive services across ambulatory and public health settings. Payers commonly involved in coverage and claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

This publication provides a concise overview of what CPT code 90477 covers, the typical clinical and service settings where it is used, and which major payers are relevant to claims and coverage patterns. Readers will find benchmarks and policy-relevant context for immunization coding, an outline of common modifiers and billing considerations, and clinical context for adenovirus type 7 vaccination programs. The summary is aimed at billing professionals, clinicians involved in immunization delivery, and policy analysts monitoring vaccine administration coding and payer coverage nationally.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare90477CPTvaccine administrationoral vaccineadenovirus type 7ambulatory carepreventive services

Billing Code Overview

CPT code 90477 describes administration of a live oral vaccine product intended to protect against adenovirus type 7, a pathogen that can cause respiratory illnesses and other clinical conditions. The code denotes the vaccine product itself delivered by oral route as a preventive immunization.

Service type: Vaccine administration — live oral vaccine product

Typical site of service: Outpatient clinic, public health clinic, or other ambulatory settings where vaccines are provided orally

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

Clinical & Coding Specifications

Clinical Context

A 6-year-old active-duty dependent presents to a military or public health clinic for routine immunization prior to a school sports camp where there is an elevated risk of adenoviral respiratory outbreaks. The nurse reviews the patient’s vaccination record, verifies contraindications (severe immunodeficiency, pregnancy, current febrile illness), obtains verbal consent from the parent, and documents lot number and expiration of the live oral adenovirus type 7 vaccine. The vaccine is administered orally per product instructions, post‑vaccination observation is performed for 15–30 minutes for immediate adverse reactions, and the immunization record and the Clinic’s electronic medical record are updated with vaccine details, informed consent, and any counseling provided. Billing staff submit the immunization claim using 90477 for the live oral adenovirus type 7 vaccine, appending appropriate modifiers if partial administration, discontinued administration, or payer‑specific requirements apply.

Coding Specifications

Modifier	Description	When to Use
`00`	Default electronic submission indicator (often not used as a billable modifier)	Use per payer system requirements when a claim submission flag is required by the clearinghouse.

CPT 90689: Inactivated Adjuvanted Quadrivalent Influenza Vaccine, 0.25 mL

cpt-90586-intravesical-live-vaccine-bladder-cancer

CPT 90586: Intravesical Live Vaccine for Bladder Cancer

90677

CPT 90677: Pneumococcal Conjugate Vaccine, 20-Valent (PCV20)

cpt-90611-smallpox-monkeypox-vaccine-subcutaneous-05ml

CPT 90611: Combined Smallpox and Monkeypox Vaccine, 0.5 mL

cpt-90647-hib-vaccine-prp-omp-three-dose

CPT 90647: Haemophilus influenzae type b (Hib) PRP–OMP Vaccine, IM

cpt-90476-adenovirus-type-4-oral-vaccine-administration

CPT 90476: Adenovirus Type 4 Oral Vaccine Administration

cpt-90687-quadrivalent-split-virus-influenza-vaccine-025-ml-pediatric

CPT 90687: Quadrivalent Split-Virus Influenza Vaccine, 0.25 mL (Pediatric)

cpt-90694-quadrivalent-influenza-adjuvanted-0-5ml-im

CPT 90694: Quadrivalent Inactivated Adjuvanted Influenza Vaccine, 0.5 mL

cpt-90733-quadrivalent-meningococcal-polysaccharide-vaccine-subcutaneous

CPT 90733: Quadrivalent Meningococcal Polysaccharide Vaccine, Subcutaneous

cpt-90653-inactivated-influenza-subunit-adjuvanted-vaccine-im-immunization

CPT 90653: Inactivated Influenza Vaccine, Subunit with Adjuvant

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care providers commonly administer routine and travel vaccines including adenovirus vaccines in clinic settings.
`208000000X`	Pediatrics	Pediatricians provide routine childhood and adolescent immunizations and counseling.
`363A00000X`	Public Health	Public health clinics and immunization programs administer population‑based vaccines and outbreak response vaccinations.
`261QM0800X`	Preventive Medicine	Preventive medicine specialists oversee immunization programs and vaccine policy implementation.
`367500000X`	Infectious Disease	Specialists consult on vaccine indications, contraindications, and high‑risk patient management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z23`	Encounter for immunization	Primary diagnosis code for preventive vaccine administration and immunization encounters.
`J06.9`	Acute upper respiratory infection, unspecified	Used when vaccinating patients during or after an upper respiratory infection evaluation where immunization is indicated and not contraindicated.
`Z71.89`	Other specified counseling	Used when specific vaccine counseling or education is a primary reason for the visit and documented.
`Z02.89`	Encounter for administrative examinations, other specified	Used in situations such as pre‑camp or military screening where immunization is administered as part of an administrative requirement.
`T88.1XXA`	Other complication of immunization, initial encounter	Used if an adverse reaction occurs to the vaccine and is treated at the initial encounter.
`Z20.822`	Contact with and (suspected) exposure to COVID-19	Included as an example of encounters where additional respiratory viral immunization strategies may be addressed in counseling during the same visit.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90460`	Immunization administration through 18 years of age via any route, with counseling when performed	Used when administration includes counseling for multiple vaccines in patients under 18; may be billed in conjunction with vaccine product codes when payer permits.
`90471`	Immunization administration (single vaccine), intramuscular or subcutaneous	Not directly for oral vaccines, but included here as a commonly used administration code for other vaccine routes in the same visit.
`90473`	Immunization administration (single vaccine) oral or intranasal	Alternative administration code for oral vaccine delivery if payer requires an administration CPT separate from product code.
`90476`	Immunization administration, include counseling for each additional vaccine (oral or intranasal)	Used for additional vaccines administered during the same encounter when counseling is provided for each one.
`90633`	Influenza virus vaccine, live, intranasal, for intranasal administration	Example of another live-virus intranasal vaccine; included for workflow context when multiple live vaccines are considered.
`99070`	Supplies and materials provided by the physician over and above those usually included with the office visit	Used to report disposable supplies related to vaccine administration if payer allows separate supply billing.

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