Summary & Overview
CPT 90673: Recombinant Trivalent Influenza Vaccine, Intramuscular
CPT code 90673 denotes a recombinant trivalent influenza vaccine that delivers a single purified viral protein and is formulated without preservatives or antibiotics. As a national immunization product, this vaccine code matters for public health planning, seasonal vaccination campaigns, and payer coverage policies because it represents a non‑egg recombinant manufacturing pathway and a preservative‑free option for intramuscular influenza prevention. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for CPT code 90673, including the vaccine’s recombinant platform, typical administration setting, and its role in seasonal influenza prevention. The publication also summarizes payer coverage considerations, common billing modifiers applicable to vaccine administration, and where this code fits relative to other influenza vaccination options. Policy updates and reimbursement benchmarks are discussed to inform billing teams, immunization program managers, and payers about coding practice and claims handling for recombinant trivalent influenza vaccines. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 90673 represents a trivalent influenza vaccine produced using recombinant DNA technology that contains a single viral protein. The vaccine is preservative‑free and antibiotic‑free and is administered as an intramuscular injection.
Service type: Vaccine administration — intramuscular immunization against influenza
Typical site of service: Outpatient clinic, physician office, pharmacy-administered clinic, or other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or adolescent presenting to a primary care clinic, occupational health clinic, pharmacy clinic, or community immunization event during influenza season for routine influenza vaccination. The patient is screened for contraindications (e.g., severe egg allergy, prior severe reaction to influenza vaccine), consent is obtained, and immunization history is reviewed. The recombinant trivalent influenza vaccine 90673 is selected for patients for whom a trivalent recombinant, preservative‑free, antibiotic‑free, intramuscular vaccine is appropriate. The vaccine is administered intramuscularly (usually deltoid for adults) with documentation of vaccine lot number, manufacturer, dose, route, site, date, and the administering clinician. Observation for immediate adverse reaction (typically 15 minutes, 30 minutes if history of prior anaphylaxis) follows per clinic protocol. Billing for the vaccine uses 90673 with appropriate payer-specific modifiers when applicable and may be accompanied by immunization administration codes when required by the payer policy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier indicated by some systems | Rarely used; some billing systems use as the default when no other modifier applies |