Influenza virus vaccine, split virus, preservative-free, 0.5 mL dosage, for intramuscular use, 3 years of age and older

Q: What is CPT code 90654?

CPT 90654 is the billing code for "Influenza virus vaccine, split virus, preservative-free, 0.5 mL dosage, for intramuscular use, 3 years of age and older". Influenza vaccine, split virus, preservative-free, age 3+

Q: What documentation is required for CPT 90654?

Key documentation requirements for CPT 90654 include: Age documented (3+); Vaccine product documented; Patient response. Missing or incomplete documentation is a leading cause of claim denials for this code.

Q: Can CPT 90654 be billed with other codes?

Bundling considerations for CPT 90654: Vaccine product code. Age 3+ only Use an NCCI bundling checker to verify specific code combinations before billing.

Q: What modifiers are commonly used with CPT 90654?

Common modifiers for CPT 90654 include: 59 (Distinct procedural service). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

Q: What is the time requirement for CPT 90654?

The typical time requirement for CPT 90654 is Vaccine product code. Time-based codes require documentation of the actual time spent providing the service.

Medicine Immunizations 0.00 Total RVUs

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Influenza vaccine, split virus, preservative-free, age 3+

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Clinical Information

When to Use

Influenza vaccine, split virus, preservative-free, age 3+

Time Requirement

Vaccine product code

Common Scenarios

Flu vaccine, age 3+

Preservative-free flu vaccine, pediatric

Split virus flu vaccine

Documentation Requirements

Age documented (3+)
Vaccine product documented
Patient response

Coding Guidelines

Common Modifiers

59 Distinct procedural service

Bundling Rules

Vaccine product code
Age 3+ only
Bill separately from administration

Exclusions

Do not bill if age <3
Do not bill with administration included

Coding Notes

Vaccine product code

Age 3+ only

Related CPT Codes

90471

Immunization administration, first/only vaccine

add-on - use for administration

90655

Influenza vaccine, split virus, preservative-free, age 6-35 months

related - different age group

Clinical scenarios

Flu vaccine, age 3+

When to use:Influenza vaccine, split virus, preservative-free, age 3+

Age documented (3+)
Vaccine product documented
Patient response

Preservative-free flu vaccine, pediatric

When to use:Influenza vaccine, split virus, preservative-free, age 3+

Age documented (3+)
Vaccine product documented
Patient response

Split virus flu vaccine

When to use:Influenza vaccine, split virus, preservative-free, age 3+

Age documented (3+)
Vaccine product documented
Patient response

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Code Details

Code 90654

Category Medicine

Subcategory Immunizations

Total RVUs 0.00

Medicare Pricing

Pricing data not available for this code.

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Frequently Asked Questions

What is CPT code 90654?

CPT 90654 is the billing code for "Influenza virus vaccine, split virus, preservative-free, 0.5 mL dosage, for intramuscular use, 3 years of age and older". Influenza vaccine, split virus, preservative-free, age 3+

What documentation is required for CPT 90654?

Key documentation requirements for CPT 90654 include: Age documented (3+); Vaccine product documented; Patient response. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 90654 be billed with other codes?

Bundling considerations for CPT 90654: Vaccine product code. Age 3+ only Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 90654?

Common modifiers for CPT 90654 include: 59 (Distinct procedural service). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 90654?

The typical time requirement for CPT 90654 is Vaccine product code. Time-based codes require documentation of the actual time spent providing the service.