Summary & Overview

CPT 90625: Cholera Vaccine, Single Oral Dose

CPT code 90625 represents oral administration of the cholera vaccine as a single dose for a patient believed to have cholera. This code captures a point-of-care immunization intervention used in acute management of suspected Vibrio cholerae infection and matters nationally because timely vaccination can be part of clinical response in outbreak settings and travel-related exposures.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and service setting for CPT code 90625, along with payer coverage scope, common modifiers listed in available input, and the types of benchmarks and policy considerations typically relevant to vaccine administration codes. The publication summarizes expected service lines and site-of-service implications, highlights where data was provided versus where input was not available, and outlines the practical billing components associated with single-dose oral vaccine administration.

This summary is intended for national audiences — clinicians, billing professionals, and policy analysts — seeking a quick reference to what CPT code 90625 denotes, which payers are typically involved, and what topics are covered in the full publication (coverage benchmarks, policy updates, and clinical context). Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 90625cholera vaccineoral vaccine administrationvaccine administrationinfectious diseaseoutpatient servicesbilling and coding

Billing Code Overview

CPT code 90625 describes administration of the cholera vaccine, given as a single oral dose to a patient believed to be suffering from cholera, an acute diarrheal illness caused by the bacterium Vibrio cholerae. The procedure involves delivering an oral immunization intended to treat or prevent the effects of the infection in an affected patient.

Service Type: Vaccine administration, oral

Typical Site of Service: Outpatient clinic, emergency department, or other point-of-care settings where oral vaccine administration and acute diarrheal illness assessment occur

Clinical & Coding Specifications

Clinical Context

A patient in an urgent care clinic presents with acute watery diarrhea, vomiting, and signs of moderate dehydration after recent travel to an area with active cholera transmission. Vital signs show tachycardia and orthostatic hypotension. The clinician performs a focused history and exam, collects stool culture or rapid testing if available, and initiates rehydration therapy (oral rehydration solution or IV fluids) as indicated. Given the clinical suspicion for cholera and the need for immediate protection and potential outbreak control, the provider administers a single-dose oral cholera vaccine using 90625. The vaccine is documented in the medical record, inclusion of lot number and expiration date is recorded, and observation for immediate adverse reaction occurs for the recommended period before discharge. Typical sites of service include urgent care centers, emergency departments, outpatient clinics, travel medicine clinics, and inpatient wards when post-exposure or during an outbreak investigation.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Default; no special circumstances affecting the service
`23`

Taxonomy Code	Specialty	Notes
`207P00000X`	Family Medicine	Common providers administering vaccines in outpatient and urgent care settings
`207RG0300X`	Internal Medicine	Adult primary care clinicians who administer travel or outbreak-related vaccines
`363A00000X`	Emergency Medicine	Emergency clinicians providing vaccine during ED visits or outbreak response
`332B00000X`	Infectious Disease	Specialists who may oversee vaccine use in outbreaks or complex exposures
`174400000X`	Public Health	Public health clinicians involved in mass vaccination or outbreak control

ICD-10 Code	Description	Clinical Relevance
`A00.0`	Cholera due to Vibrio cholerae 01, biovar cholerae	Primary diagnosis when cholera infection is confirmed; `90625` corresponds to vaccine for cholera
`A00.9`	Cholera, unspecified	Used when cholera is diagnosed but specific organism details are not coded; vaccine may be given in suspected cases
`A09.9`	Infectious gastroenteritis and colitis, unspecified	Symptomatic presentation that may prompt empiric measures including vaccination during outbreaks or high-risk exposures
`R11.0`	Nausea	Symptom code accompanying diarrheal illness; relevant to clinical presentation but not a primary indication for vaccine alone
`R19.7`	Diarrhea, unspecified	Symptom code used in documentation of acute diarrheal illness where cholera is a consideration

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Often billed for injectable vaccines; not used for `90625` (oral), but included when co-administering an injectable vaccine during the same visit
`90471`	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular) when performed; single vaccine/toxoid	Not directly used for oral vaccine `90625`; similar administration codes may be considered by some payors — documentation must support route and code selection
`90460`	Immunization administration through 18 years via any route; first component vaccine	Used for pediatric immunization encounters with counseling and administration; not typical for single-dose adult oral cholera vaccine but relevant if patient is a child and payor requires separate admin code
`36300`	Colony count or stool studies (example) [Note: placeholder for stool testing codes such as `87045`]	Diagnostic stool testing codes (e.g., stool culture `87045`) are commonly ordered before or alongside treatment and public health reporting
`G0008`	Administration of influenza vaccine (Medicare)	Example of a vaccine administration HCPCS; inclusion shows that administration reporting codes exist for payors though `90625` includes the vaccine product itself

Note: If exact administration or immunization administration codes are required by a payer, separate billing may follow payer-specific rules; 90625 describes the oral cholera vaccine product administration as reported by the vaccine code itself.

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