Summary & Overview
CPT 90687: Quadrivalent Split-Virus Influenza Vaccine, 0.25 mL (Pediatric)
CPT code 90687 designates a split-virus, quadrivalent influenza vaccine administered intramuscularly as a 0.25 mL dose, primarily for younger children. As a commonly used pediatric influenza immunization, this code is central to seasonal vaccination programs and pediatric preventive care. Nationally, 90687 matters for public health vaccination coverage, payer vaccine-payment policies, and clinic-level operational planning during influenza season.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of where 90687 is used clinically, typical sites of service, and common billing considerations. The publication summarizes benchmarks for utilization and reimbursement patterns, highlights payer coverage approaches and policy updates affecting vaccine claims, and clarifies clinical context such as age-based dosing and intramuscular administration.
The content provides practical reference material for billing staff, practice managers, and policy analysts seeking clear definitions and national payer coverage orientation for this pediatric influenza vaccine code. Data not available in the input are noted where relevant.
Billing Code Overview
CPT code 90687 represents an intramuscular influenza vaccine formulated as a split virus, quadrivalent preparation given in a 0.25 mL dose. The product is intended for administration to young children to provide protection against four influenza virus strains for the influenza season.
Service type: Vaccine administration (intramuscular vaccination)
Typical site of service: Outpatient clinic, pediatrician's office, public health clinic, or other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A 2-year-old child presents to a pediatric clinic during influenza season for routine immunization. The child has no acute illness, is up to date on prior immunizations, and has parental consent for administration of the influenza vaccine. After a brief screening for contraindications and review of prior influenza vaccine history, a nurse prepares the age-appropriate intramuscular product and administers 90687 as a 0.25 mL split-virus quadrivalent influenza vaccine into the anterolateral thigh. The nurse documents vaccine lot number, manufacturer, administration site, route, date, patient’s weight, and VIS publication and date in the electronic medical record. The child is observed for 15 minutes for immediate adverse reactions and a vaccine record is provided to the parent. Billing is submitted for the vaccine using CPT 90687 with appropriate patient identifiers and, if applicable, an administration code and modifier describing payer or clinical circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default when no other modifier applies to the service |