Summary & Overview
CPT 90671: Pneumococcal 15-Valent Vaccine, Intramuscular
CPT code 90671 denotes a 15-valent pneumococcal vaccine administered intramuscularly to prevent pneumococcal disease. As a routine preventive and catch-up immunization option, this vaccine matters nationally for reducing invasive pneumococcal infections, protecting high-risk populations, and supporting public health vaccination goals. Coverage, coding, and billing practices for this product influence vaccine access, clinical workflows, and revenue streams across outpatient settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The review outlines payer coverage patterns and common billing considerations relevant to vaccine administration in outpatient clinics, physician offices, and pharmacies.
Readers will learn the clinical context for the vaccine, typical sites of service, and what to expect in payer interactions and documentation. The publication summarizes benchmarks and common payer approaches, highlights relevant policy and coverage topics, and provides practical billing context for coding the vaccine product. Data not available in the input will be identified explicitly where applicable.
Billing Code Overview
CPT code 90671 represents an intramuscular pneumococcal 15-valent vaccine administered to protect against pneumococcal disease caused by multiple strains of Streptococcus pneumoniae. The code denotes the vaccine product itself and the act of immunization.
Service Type: Vaccination / Immunization
Typical Site of Service: Outpatient clinic, physician office, pharmacy immunization area, or other outpatient immunization settings
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with chronic obstructive pulmonary disease (COPD) presents to an outpatient primary care clinic for routine preventive care. The clinician reviews immunization history and documents that the patient has not received a 15‑valent pneumococcal conjugate vaccine. After confirming no contraindications (severe allergy to vaccine components) and obtaining verbal consent, the medical assistant prepares the intramuscular injection in the deltoid. The clinician administers the vaccine during the same visit, documents lot number, manufacturer, site, and patient response in the medical record, and provides vaccine information statement and follow-up guidance. Billing is submitted using 90671 for the vaccine product administered intramuscularly to protect against pneumococcal disease. Typical site of service is an outpatient clinic or physician office; this service may also be provided in long‑term care or community immunization clinics. Typical service type is preventive immunization (vaccine administration) given intramuscularly to adults and eligible patients according to current immunization schedules.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No specific modifier — standard reporting | Use when no modifier reporting requirement applies. |