CPT 90585: Tuberculosis Live Vaccine, Intradermal Administration - OpenPayer

Summary & Overview

CPT 90585: Tuberculosis Live Vaccine, Intradermal Administration

CPT code 90585 denotes a live vaccine product administered through the skin to protect against tuberculosis. This code identifies intradermal delivery of a live attenuated mycobacterial vaccine used in preventive public health and clinical immunization programs. Nationally, accurate coding for TB vaccination supports surveillance, public health reporting, and appropriate claims adjudication for preventive services.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of the clinical context for CPT code 90585, the typical service setting, and which major payers are relevant for coverage and claims processing. The publication summarizes common billing modifiers (provided), typical sites of service, and practical coding considerations for vaccine administration claims.

The report covers benchmarks and policy context relevant to national payers, outlines areas where code-specific guidance commonly matters (vaccine product identification, administration route, and site of service), and highlights where additional payer-specific rules or prior authorization requirements may appear. Data not available in the input (such as associated taxonomies, ICD-10 diagnoses, and related codes) are noted as missing.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare90585CPTvaccinetuberculosisintradermalvaccine-administrationpreventive-careambulatory-care

Billing Code Overview

CPT code 90585 represents a live vaccine product administered through the skin to protect against tuberculosis (TB). The service involves delivery of a live attenuated mycobacterial vaccine intended to stimulate protective immunity against tuberculosis.

Service type: Vaccine administration (intradermal live vaccine)

Typical site of service: Outpatient clinic, public health clinic, or other ambulatory care settings

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

Clinical & Coding Specifications

Clinical Context

A 28-year-old immigrant presents to a public health clinic for tuberculosis (TB) screening and prevention. The patient has no history of prior TB vaccination or documented Bacillus Calmette–Guérin (BCG) vaccine and is scheduled for intradermal administration of a live TB vaccine product. Pre-procedure documentation includes clinical history, allergy review, informed consent, and verification of vaccine lot number and expiration. The procedure is performed in an outpatient clinic or public health department exam room. The provider — typically a nurse or physician trained in vaccine delivery — prepares the intradermal site (usually the volar aspect of the forearm), administers the vaccine using aseptic technique, records the administration in the patient’s chart and immunization registry, and provides post-vaccination guidance on expected local reactions and when to return for evaluation. If immediate adverse reaction occurs, emergency equipment and protocols are available on site. Billing uses 90585 for the live intradermal TB vaccine product administered through the skin; documentation should include vaccine name, dose, route (intradermal), site of administration, lot number, manufacturer, and the identity of the administering clinician.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Use when no other modifier applies and full service is rendered

CPT 90682: Quadrivalent Recombinant Influenza Vaccine, IM

cpt-90749-unlisted-vaccine-or-toxoid-procedure

CPT 90749: Unlisted Vaccine or Toxoid Procedure

cpt-90691-typhoid-vi-capsular-polysaccharide-intramuscular-vaccine

CPT 90691: Intramuscular Typhoid Vi Capsular Polysaccharide Vaccine

cpt-90666-preservative-free-pandemic-influenza-split-virus-immunization

CPT 90666: Preservative-Free Pandemic Influenza Vaccine, Split Virus

cpt-90672-quadrivalent-live-intranasal-influenza-vaccine

CPT 90672: Quadrivalent Live Intranasal Influenza Vaccine

cpt-90655-preservative-free-trivalent-influenza-vaccine-025ml-im-immunization

CPT 90655: Preservative-Free Trivalent Influenza Vaccine, 0.25 mL IM

cpt-90673-recombinant-trivalent-influenza-vaccine-im-injection

CPT 90673: Recombinant Trivalent Influenza Vaccine, Intramuscular

cpt-90678-rsv-bivalent-prefusion-f-vaccine-im-injection

CPT 90678: Bivalent Prefusion F RSV Vaccine, Intramuscular

cpt-90695-h5n8-adjuvanted-cell-culture-influenza-vaccine

CPT 90695: H5N8 Adjuvanted Cell-Culture Influenza Vaccine

cpt-90636-hepatitis-a-b-combined-vaccine-adult-immunization

CPT 90636: Adult Intramuscular Hepatitis A and B Combined Vaccine

Showing 1–10 of 101

Taxonomy Code	Specialty	Notes
`163W00000X`	Preventive Medicine Physician	Public health and preventive services oversight
`363L00000X`	Family Medicine Physician	Common primary care provider administering vaccinations
`207Q00000X`	Internal Medicine Physician	Adult primary care clinicians providing immunizations
`364S00000X`	Nurse Practitioner	Frequently administers vaccines in outpatient settings
`367500000X`	Physician Assistant	Performs vaccine administration under physician supervision

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A15.0`	Tuberculosis of lung, bacteriologically and histologically confirmed	Active pulmonary TB is a primary condition related to TB screening and prevention strategies; vaccine consideration may be part of public health efforts in contacts or endemic settings
`A16.2`	Respiratory tuberculosis unspecified, bacteriological and histological examination not done	Used in evaluation of suspected TB where vaccination history and prevention are part of public health workflow
`Z23`	Encounter for immunization	Primary diagnosis code used when the visit is for vaccine administration such as intradermal TB vaccine
`Z11.1`	Encounter for screening for respiratory tuberculosis	Indicates screening context where intradermal TB vaccine may be administered as part of prevention programs or contact management
`Z71.88`	Other specified counseling	Used when counseling regarding TB prevention or vaccine risks/benefits is provided during the visit

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90460`	Immunization administration through 18 years of age via any route; with counseling by physician or other qualified health care professional	Used when administration includes physician counseling for pediatric patients; documents counseling time alongside vaccine administration
`90471`	Immunization administration (single vaccine) for injection, intranasal, or oral, without counseling by physician or other qualified health care professional	Commonly used for single-dose vaccine administration when counseling is not separately reported; may be reported in addition to vaccine product code when applicable
`90736`	Varicella vaccine, live, for subcutaneous injection, per vaccine	Example of another live vaccine product code; related as part of immunization program workflows and inventory management
`90474`	Immunization administration, each additional vaccine (same date)	Used when multiple vaccines are administered during the same encounter; documents additional administration services beyond the first
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Example of a brief counseling service that may be billed during the same preventive visit; represents common concurrent counseling services in public health clinics

If additional vaccine product or administration codes are required in a specific workflow, these codes are commonly used alongside 90585 to document administration and counseling components.

OpenPayer