Summary & Overview
CPT 90734: Meningococcal Conjugate Vaccine (MenACWY) Administration
CPT code 90734 represents administration of a meningococcal conjugate vaccine (MenACWY) using a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM). This preventive immunization reduces risk of invasive meningococcal disease, including meningitis and septicemia, conditions with high morbidity and mortality. As a routinely recommended vaccine for certain adolescents, young adults, and high‑risk groups, proper coding of 90734 supports accurate reporting of immunization services and public health surveillance.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for MenACWY vaccination, common payer coverage patterns, relevant billing considerations, and benchmarkable metrics for vaccine administration claims. The publication covers coding specifics for 90734, typical sites of service (ambulatory clinics and physician offices), and common modifiers used in practice (full modifier list provided elsewhere in the document). The content is intended to help billing managers, revenue cycle staff, and policy analysts understand where 90734 fits in preventive care workflows, payer interactions, and claims reporting nationally.
Billing Code Overview
CPT code 90734 describes administration of a meningococcal conjugate vaccine delivered in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM). The vaccine protects against four strains of Neisseria meningitidis that can cause serious illness such as meningitis and septicemia (sepsis).
Service Type: Vaccine administration — meningococcal conjugate (MenACWY)
Typical Site of Service: Outpatient clinic, physician office, or other ambulatory care settings where routine immunizations are provided.
Clinical & Coding Specifications
Clinical Context
A healthy adolescent or young adult presents to an outpatient primary care clinic for routine immunizations prior to college entry or group living. The provider reviews immunization history, screens for contraindications (severe allergic reaction to a previous dose or vaccine component), obtains informed consent, documents lot number and VIS, and administers the meningococcal conjugate vaccine (90734) intramuscularly in the deltoid. The clinical workflow includes verification of identity and insurance, assessment of current health status, counseling on expected local and systemic reactions, administration of the vaccine, observation for 15 minutes for adverse reactions, documentation in the electronic health record and state immunization registry, and billing to the patient’s payer for vaccine administration and the vaccine product as applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the same day | Use when a separate evaluation and management visit is provided in addition to vaccine administration during the same encounter. |
59 |