CPT 90714: Diphtheria and Tetanus Preservative‑Free Vaccine IM

CPT code 90714 denotes the intramuscular administration of a preservative‑free combination diphtheria and tetanus toxoid vaccine for individuals older than seven years. As a common immunization entry in outpatient care, this code supports preventive services that reduce morbidity and public health risk from diphtheria and tetanus. Its use matters nationally because routine and catch‑up immunizations are foundational to population health programs and payer coverage policies.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus operational benchmarks and coding considerations relevant to immunization administration billing. The report highlights common modifier usage and payer patterns where available, and summarizes how 90714 fits into immunization workflows and documentation practices.

This summary equips billing managers, clinicians, and policy analysts with the core facts needed to interpret claims, align documentation with vaccine administration, and understand where 90714 is applied across ambulatory settings. Data not available in the input is explicitly noted where applicable in detailed sections.

Billing Code Overview

CPT code 90714 describes the administration of a preservative-free combination vaccine for diphtheria and tetanus toxoids given intramuscularly to an individual older than seven years for prevention of diphtheria and tetanus. The service is an immunization administration involving a single intramuscular injection of the specified vaccine formulation.

Service Type

Immunization administration

Typical Site of Service

Outpatient clinic or physician office
Public health clinic or community vaccination site
School-based health center or similar ambulatory setting

Clinical Context

A 28-year-old adult presents to a primary care clinic for routine immunization after a tetanus-prone laceration sustained while gardening. The clinician reviews immunization history, documents contraindications and informed consent, checks prior tetanus-diphtheria vaccine dates, and verifies no severe egg/latex allergies or prior anaphylaxis to vaccine components. The provider administers a preservative-free combination intramuscular vaccine for diphtheria and tetanus toxoids (90714) into the deltoid. Post‑vaccination observation is performed for 15–30 minutes for immediate adverse reactions. Documentation includes vaccine brand, lot number, expiration date, site and route of administration, informed consent, and vaccination record entry. Billing is submitted under the office visit or immunization service line with 90714 and applicable modifiers if required by payer policy.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service	Use when the patient receives an E/M visit that is distinct from the immunization encounter on the same day (e.g., evaluation of wound and counseling plus `90714`).

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary providers who commonly administer routine adult immunizations.
`207R00000X`	Internal Medicine	Adult primary care clinicians administering tetanus-diphtheria vaccines.
`3336C0001X`	Emergency Medicine	Emergency clinicians administering tetanus vaccine for wound management.
`207K00000X`	Pediatric Medicine	May administer `90714` for patients older than seven years transitioning from pediatric care.
`363LF0000X`	Public Health Immunization Provider	Providers focused on vaccine delivery and community immunization programs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z23`	Encounter for immunization	Primary billing justification for administering `90714` when giving routine tetanus-diphtheria immunization.
`S01.80XA`	Other superficial injury of other part of head, initial encounter	Represents a tetanus-prone wound scenario prompting tetanus immunization in adults.
`S61.001A`	Unspecified open wound, right finger, initial encounter	Example of a tetanus-prone laceration where `90714` may be administered as prophylaxis.
`T81.4XXA`	Infection following a procedure, initial encounter	Post‑procedural infections may prompt review of immunization status and administration of tetanus toxoid when indicated.
`Z28.1`	Underimmunization status	Used when a patient is underimmunized and receives indicated tetanus-diphtheria vaccination.
`R22.9`	Localized swelling, unspecified	May be used when documenting local reaction post injection if significant and clinically relevant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90460`	Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered	Often used for pediatric vaccine counseling and administration; not typical for adult `90714` but relevant when counseling is billed for vaccine services in younger populations.
`90471`	Immunization administration (per single vaccine/toxoid), intramuscular, for one vaccine/toxoid	Alternative administration code sometimes reported for single adult vaccine administration when payer requires explicit administration code separate from vaccine product code.
`90472`	Each additional vaccine/toxoid (intramuscular)	Used if more than one vaccine is administered during the same visit in addition to `90714`.
`90473`	Immunization administration (per single vaccine/toxoid) intranasal or oral	Relevant when oral/intranasal vaccines are administered in the same encounter.
`G0008`	Administration of influenza virus vaccine	Common contemporaneous vaccine administration code for seasonal flu when multiple vaccines are given during a visit.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M code billed on the same day when a significant, separate E/M service is provided in addition to vaccine administration; may be reported with modifier `25` when appropriate.

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Summary & Overview