Influenza virus vaccine, split virus, 0.25 mL dosage, for intramuscular use, 6 through 35 months of age
Relative Value Units (RVUs)
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Clinical Information
When to Use
Influenza vaccine, split virus, age 6-35 months
Common Scenarios
Documentation Requirements
- Age documented (6-35 months)
- Vaccine product documented
- Patient response
Coding Guidelines
Common Modifiers
Bundling Rules
- Vaccine product code
- Age 6-35 months only
- Bill separately from administration
Exclusions
- Do not bill if age outside 6-35 months
- Do not bill with administration included
Coding Notes
Clinical scenarios
- Age documented (6-35 months)
- Vaccine product documented
- Patient response
- Age documented (6-35 months)
- Vaccine product documented
- Patient response
- Age documented (6-35 months)
- Vaccine product documented
- Patient response
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
Dosage: 0.25 ML
Payment Limit: $11.03
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Get instant answers about 90657 - pricing, bundling rules, or billing questions.
Ask a QuestionFrequently Asked Questions
CPT 90657 is the billing code for "Influenza virus vaccine, split virus, 0.25 mL dosage, for intramuscular use, 6 through 35 months of age". Influenza vaccine, split virus, age 6-35 months
Key documentation requirements for CPT 90657 include: Age documented (6-35 months); Vaccine product documented; Patient response. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 90657: Vaccine product code. Age 6-35 months only Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 90657 include: 59 (Distinct procedural service). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 90657 is Vaccine product code. Time-based codes require documentation of the actual time spent providing the service.