Summary & Overview
CPT 90672: Quadrivalent Live Intranasal Influenza Vaccine
CPT code 90672 designates a quadrivalent live attenuated influenza vaccine delivered as a nasal spray. This preventive vaccine targets four influenza strains to reduce seasonal flu morbidity and transmission, particularly among pediatric and select adult populations suited to intranasal administration. As a widely used delivery form for influenza immunization programs, the code is relevant for clinicians, immunization clinics, pharmacies, and payers managing preventive care coverage nationally.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, common billing modifiers associated with immunization services, and clinical context for use of the intranasal quadrivalent vaccine. Readers will find benchmarks on utilization and coverage (where available), coding guidance for service classification, and summaries of policy updates that affect vaccine administration coding and reimbursement. The briefing also explains typical sites of service and operational considerations for documenting administration of intranasal influenza vaccine.
Data not available in the input will be noted where applicable. The content is intended as a national overview of CPT code 90672 and its role in seasonal influenza vaccination programs.
Billing Code Overview
CPT code 90672 represents a quadrivalent live attenuated influenza vaccine administered as a nasal spray to protect against seasonal influenza. The product contains four different influenza virus strains (two influenza A and two influenza B strains) formulated for intranasal delivery.
Service type: Vaccine administration (intranasal), preventive immunization
Typical site of service: Outpatient clinic, primary care office, public health clinic, school-based clinic, or pharmacy clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A healthy pediatric patient aged 2–8 years presents to a primary care clinic during influenza season for routine immunization. The clinician reviews immunization history, confirms no contraindications to live attenuated influenza vaccine (LAIV), verifies administration eligibility for the quadrivalent intranasal formulation, and documents informed consent. The nurse prepares the 90672 product (quadrivalent live intranasal influenza vaccine), inspects the device, and administers the nasal spray per manufacturer technique (one spray per nostril). The nurse monitors the patient for immediate adverse reactions for 15 minutes, documents lot number and expiration, updates the immunization record, and provides vaccine information statement to the caregiver. Billing is submitted using 90672 with applicable payer and facility details; common payer interactions include coverage verification with Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for eligible populations.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Used when no specific modifier applies to the service |