Summary & Overview
CPT 90624: Pentavalent Meningococcal Vaccine, Intramuscular
CPT code 90624 denotes a pentavalent meningococcal vaccine given intramuscularly to protect against five serogroups of Neisseria meningitidis. Nationally, meningococcal vaccination is a critical preventive measure for at-risk populations and for controlling outbreaks; a code-specific understanding supports accurate immunization reporting, coverage determinations, and public health tracking. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of what CPT code 90624 represents, the clinical contexts in which the vaccine is used, and typical sites of administration. The publication summarizes payer coverage patterns, billing and coding considerations, and common modifiers used with vaccine administration claims where available. It also provides benchmarks and policy-relevant updates affecting reimbursement and eligibility for meningococcal vaccination, along with clinical context about the pentavalent formulation and its role in prevention strategies. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 90624 represents a pentavalent meningococcal vaccine administered via intramuscular injection to protect against five serogroups of meningococcal disease. This vaccine product is intended for active immunization to prevent invasive meningococcal infections caused by multiple serogroups.
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Service type: Vaccine administration (intramuscular)
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Typical site of service: Outpatient clinics, primary care offices, community immunization centers, school-based health centers, and other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A 16-year-old adolescent presents to a primary care clinic for routine immunization prior to starting college residence. The patient is medically stable, with no acute febrile illness, and has a documented history of incomplete meningococcal immunization. After verification of vaccine history and screening for contraindications (severe allergic reaction to a prior meningococcal vaccine component), the clinician obtains informed consent, documents lot number and manufacturer, and administers the pentavalent meningococcal conjugate vaccine intramuscularly in the deltoid using standard aseptic technique. Post-vaccination observation occurs for 15 minutes to monitor for immediate adverse reactions. Documentation includes vaccine product name, CPT code 90624, dose, route, site, lot number, expiration date, VIS edition and date, and patient counseling.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—standard reporting | Use when no special circumstances apply. |
| 22 | Increased procedural services | Use if unusually extensive counseling or administration complexity occurred. |
| | Unusual anesthesia | Rare for routine IM vaccination; use only if general anesthesia or monitored anesthesia was required. |