Summary & Overview
CPT 90691: Intramuscular Typhoid Vi Capsular Polysaccharide Vaccine
CPT code 90691 identifies an intramuscular typhoid vaccine composed of the Vi capsular polysaccharide, used to prevent typhoid fever. As a single-antigen injectable vaccine, it is relevant to preventive care, travel medicine, and public health immunization programs. Nationally, this code matters for tracking vaccine utilization, ensuring appropriate billing for travel and preventive services, and aligning coverage policies across commercial and public payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical purpose and typical settings, plus payer coverage framing and common billing considerations. The publication outlines expected benchmarks for coding and claims processing, notes typical sites of service where 90691 is used, and highlights policy and coverage themes that affect reimbursement and access to the typhoid Vi polysaccharide vaccine.
The content provides clinical context for the vaccination, summarizes how payers approach coverage for travel and preventive vaccines, and points to operational items relevant to billing teams and immunization clinics. Data not available in the input will be identified where necessary.
Billing Code Overview
CPT code 90691 represents an intramuscular typhoid vaccine formulation containing the Vi capsular polysaccharide, a purified bacterial component designed to protect against typhoid fever. The product is administered by intramuscular injection.
Service type: Vaccine administration / Preventive immunization service
Typical site of service: Outpatient clinics, primary care offices, travel medicine clinics, and immunization centers
Clinical & Coding Specifications
Clinical Context
A 28-year-old adult presents to a travel clinic prior to international travel to a typhoid-endemic region. After review of travel itinerary and immunization history, the clinician recommends intramuscular typhoid Vi capsular polysaccharide vaccine. The encounter includes screening for contraindications (eg, severe allergy to vaccine components), informed consent, administration of a single intramuscular injection (typically deltoid), observation for immediate adverse reaction for 15–30 minutes, and documentation in the immunization record and electronic health record. Billing uses the vaccine product code 90691; the visit may be billed with an evaluation and management code if significant, separately identifiable services are provided and an appropriate modifier is appended when required. Typical site of service is an outpatient clinic, travel medicine clinic, community health center, or urgent care setting. The typical patient scenario includes routine pre-travel counseling, vaccine administration, and post-vaccination observation for a healthy adult without acute illness.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day | Use when a distinct E/M visit is provided in addition to vaccine administration and documentation supports a separate E/M service. |