Summary & Overview
CPT 90723: Combination Inactivated DTaP–HepB–IPV Vaccine IM
CPT code 90723 denotes administration of a combination inactivated intramuscular vaccine that protects against diphtheria, tetanus, acellular pertussis, hepatitis B, and poliomyelitis. This single-administration vaccine code matters nationally because combination vaccines streamline immunization schedules, reduce clinic visits, and support public health efforts to maintain high childhood and adult vaccination coverage.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is used in ambulatory and clinic settings, common billing considerations, and the clinical context for its use. The report summarizes typical settings for administration, common modifiers in use (list provided separately), and how payers commonly handle coverage and claims for multi-antigen inactivated vaccines.
This publication provides benchmarks on utilization and coverage patterns where available, highlights relevant policy and coding considerations for vaccine administration, and clarifies the clinical scenarios that commonly justify use of CPT code 90723. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 90723 describes administration of a combination inactivated intramuscular vaccine designed to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio. The code represents a single vaccine administration event in which the provider gives a multi-component inactivated vaccine by intramuscular injection.
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Service type: Vaccine administration (combination inactivated vaccine)
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Typical site of service: Outpatient clinic, primary care office, public health clinic, or other ambulatory care settings where intramuscular vaccinations are routinely given.
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adult patient presenting for routine immunization or catch-up vaccination. The patient may be in a primary care clinic, pediatric clinic, public health clinic, occupational health clinic, pharmacy, or community immunization event. The clinical workflow includes patient identification and consent, review of immunization history and contraindications, screening for acute illness or allergies, preparation of the combination inactivated vaccine that covers diphtheria, tetanus, acellular pertussis, hepatitis B, and poliovirus, intramuscular administration (usually deltoid for adults and older children or anterolateral thigh for infants), documentation of vaccine lot number and site, observation for immediate adverse reactions, and billing of the administration service under 90723 with any applicable modifier. Vaccination is commonly given as part of routine childhood series, adolescent or adult boosters, or catch-up schedules for unimmunized or underimmunized individuals.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Placeholder/Not used for Medicare claims processing in general | Rarely used; present in list but not typically appended to vaccine administration codes |
25 |