Summary & Overview
CPT 90581: Anthrax Vaccine, Injectable
CPT code 90581 designates an anthrax vaccine administered via injection to protect against anthrax, a rare but potentially severe bacterial infection. As a vaccine product code, it is relevant for public health immunization programs, occupational health for at-risk populations, and preparedness efforts for biological threats. Nationally, anthrax vaccination is a specialized preventive service with implications for clinical protocols, coverage determinations, and vaccine supply logistics.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context and typical service settings, followed by benchmark and policy-focused sections that address coverage patterns, billing considerations, and coding practice implications. The publication outlines payer coverage approaches, claims processing notes, and common modifier usage where applicable. It also highlights issues important for immunization programs and employers managing occupational exposures.
This summary provides a national perspective on the clinical purpose and administrative handling of CPT code 90581, helping billing professionals, policy analysts, and health administrators understand where the code fits within vaccine delivery and payer reimbursement frameworks. Data not available in the input will be noted within relevant sections.
Billing Code Overview
CPT code 90581 represents an anthrax vaccine product administered by injection to protect against anthrax infection. This service is a preventive immunization intended to induce protective immunity against Bacillus anthracis.
Service Type: Vaccine administration (injection)
Typical Site of Service: Clinic, outpatient vaccination center, public health clinic, or other outpatient settings where injectable immunizations are provided.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old laboratory technician with occupational exposure risk to Bacillus anthracis presents to an outpatient occupational health clinic for administration of the anthrax vaccine via intramuscular injection. The clinical workflow includes verification of employee immunization status and consent, review for contraindications (severe allergic reaction to prior dose or vaccine component), medication and allergy reconciliation, and documentation of the vaccine lot number, expiration, manufacturer, injection site, and route. The patient receives the vaccine (single dose administration for this encounter), is observed for 15–30 minutes for immediate adverse reactions, and is provided with vaccine information and follow-up scheduling for subsequent doses per the immunization schedule. Billing is submitted using 90581 for the vaccine product administered by injection, with the encounter typically occurring in an outpatient clinic, occupational health clinic, or public health vaccination site.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; typically not appended when a specific modifier applies |
22 |