Summary & Overview
CPT 90700: DTaP Vaccine for Children Under 7
CPT code 90700 represents an intramuscular DTaP vaccine product administered to children under 7 years to prevent diphtheria, tetanus, and pertussis. Nationally, childhood immunization codes like 90700 are central to preventive care delivery, public health goals for herd immunity, and routine pediatric care workflows. Accurate coding supports vaccine coverage, timely reporting, and claims processing across public and private payers.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the vaccine, common payer coverage considerations, and typical sites of service. The publication provides benchmarks for coding and billing practices where available and summarizes relevant policy and reimbursement considerations that affect administration and claims submission nationally.
This summary also outlines what readers will learn: the clinical indication and patient population for 90700, typical care settings for administration, implications for provider billing operations, and guidance on where to find further payer-specific coverage information. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 90700 describes a DTaP vaccine product administered intramuscularly to protect against diphtheria, tetanus, and pertussis (whooping cough). This code is used for children younger than 7 years of age.
Service type: Vaccine administration / Immunization product
Typical site of service: Pediatric clinic, primary care office, public health clinic, or other outpatient ambulatory settings where childhood immunizations are provided.
Clinical & Coding Specifications
Clinical Context
A 4-month-old infant presents to a pediatric outpatient clinic for routine immunizations as part of the primary childhood immunization schedule. The clinician verifies immunization history, reviews contraindications and allergies, obtains parental consent, and documents weight and vital signs. The vaccine selected is a diphtheria, tetanus, and acellular pertussis (DTaP) product administered intramuscularly, typically in the anterolateral thigh for infants. The healthcare team prepares the single-dose syringe from the clinic stock, applies appropriate infection-control procedures, and administers the intramuscular injection using a needle and syringe appropriate for age and muscle mass. Post-vaccination, the patient is observed for 15 minutes for immediate adverse reactions, counseling is provided on expected local and systemic reactions, and the immunization is recorded in the patient chart and the state immunization registry.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | General use when no special modifier applies |
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day |