Summary & Overview
CPT 90627: Inactivated Intramuscular Vaccine for Tick-Borne Viral Encephalitis
CPT code 90627 describes an inactivated intramuscular vaccine supplied as a 0.5 mL dose for prevention of viral encephalitis transmitted by ticks. This immunization is part of preventive care strategies against vector-borne viral neurologic disease and is relevant to clinicians administering travel- or exposure-related vaccines and to payers covering immunization services. Nationally, vaccines for tick-borne encephalitis are important for at-risk populations, including travelers to endemic areas and people with occupational or recreational exposure that increases tick contact.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on the clinical purpose and administration context of the vaccine, the typical sites of service where it is provided, and which major payers are considered. The publication also summarizes common billing modifiers and notes where input data was not available. The intent is to provide billing and clinical staff, policy analysts, and payer contract teams with a clear, national-level overview of CPT code 90627, its clinical use, and administrative context without state-specific detail.
Billing Code Overview
CPT code 90627 represents an inactivated intramuscular vaccine formulation provided as a 0.5 mL dose to protect against viral encephalitis transmitted by ticks. The product is administered by intramuscular injection and is intended for active immunization to prevent tick-borne viral encephalitis.
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Service type: Vaccine administration (intramuscular) and immunization for tick-borne viral encephalitis
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Typical site of service: Outpatient clinic, physician office, public health clinic, or other ambulatory care settings where routine immunizations are given
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 45-year-old outdoor worker presents to an ambulatory clinic during tick season requesting prevention against tick-borne viral encephalitis. The clinician confirms vaccination history and contraindications, obtains informed consent, documents lot number and site, and administers a 0.5 mL intramuscular dose of the inactivated tick-borne encephalitis vaccine (90627) into the deltoid. Observation for 15 minutes follows for immediate adverse reactions. Documentation includes vaccine product name, manufacturer, NDC, lot number, expiration date, route, site, dose, and the administering provider. Billing is submitted from an outpatient clinic or occupational health clinic using the vaccine code 90627 and appropriate modifier if applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no special circumstances apply to the billed service |
23 | Unusual anesthesia | Rarely applicable; use only if additional anesthesia unrelated to routine injection is required |