Effective 1/1/2016
Commonly Administered Pediatric Vaccines
CPT ®
Product
Code
90620
90621
90630
90633
90644
90647
90648
90649
90650
90651
90655
Separately report the administration with Current Procedural Terminology (CPT®)
codes 90460-90461 or 90471-90474 [Please see table below]
Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B, 2 dose
schedule, for IM use
Meningococcal recombinant lipoprotein vaccine, serogroup B, 3 dose schedule, for IM use
Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use
Hepatitis A vaccine(Hep A), pediatric/adolescent dosage, 2 dose, for IM use
Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine
(MenCY-Hib), 4-dose schedule, when administered to children 6 weeks – 18 months of age, for
IM use
Hemophilus influenza B vaccine (Hib), PRP-OMP conjugate, 3 dose, for IM use
Hemophilus influenza B vaccine (Hib), PRP-T conjugate, 4 dose, for IM use
Human Papilloma virus vaccine, types 6, 11, 16, 18 quadrivalent (HPV4), 3 dose schedule, for
IM use
Human Papilloma virus vaccine, types 16 and 18, bivalent (HPV2), 3 dose schedule, for IM use
Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (HPV), 3 dose
schedule, for IM use
Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, for children 6-35 months of
age, for IM use
Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to 3
years of age and above, for IM use
90656
90657
Influenza virus vaccine, trivalent (IIV3), split virus, 6–35 months dosage, for IM use
Influenza virus vaccine, trivalent (IIV3), split virus, 3 years and older dosage, for IM use
90658
90670
90672
90680
90681
90685
90686
90687
90688
90696
90697
90698
90700
Pneumococcal conjugate vaccine, 13 valent (PCV13), for IM use
Influenza virus vaccine, quadrivalent (LAIV), live, intranasal use
Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use
Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use
Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for children 6-35 months
of age, for IM use
Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to 3
years of age and above, for IM use
Influenza virus vaccine, quadrivalent (IIV4), split virus, 6–35 months dosage, for IM use
Influenza virus vaccine, quadrivalent (IIV4), split virus, 3 years and older dosage, for IM use
Diphtheria, tetanus toxoids, and acellular pertussis vaccine and inactivated poliovirus vaccine
(DTaP-IPV), when administered to children 4 years through 6 years of age, for IM use
Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine,
Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPVHib-HepB), for IM use
Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza Type B, and
inactivated poliovirus vaccine (DTaP -IPV/Hib), for IM use
Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to
younger than seven years, for IM use
Manufacturer
Brand
Novartis
Bexsero
Pfizer
Sanofi Pasteur
GlaxoSmithKline
Merck
Trumenba
Fluzone Intradermal
Quadrivalent
HAVRIX
VAQTA
GlaxoSmithKline
MenHibrix
Merck
sanofi pasteur
GlaxoSmithKline
Merck
PedvaxHIB
ActHIB
HIBERIX
GARDASIL
GlaxoSmithKline
Merck
CERVARIX
GARDASIL 9
sanofi pasteur
Merck
sanofi pasteur
Novatis
GlaxoSmithKline
GlaxoSmithKline
Sanofi Pasteur
Merck
GlaxoSmithKline
sanofi pasteur
Novartis
Pfizer
MedImmune
Merck
GlaxoSmithKline
Fluzone No Preservative
Pediatric
AFLURIA
Fluzone No Preservative
Fluvirin
FLUARIX
FLULAVAL
Fluzone
AFLURIA
FLULAVAL
Fluzone
Fluvirin
PREVNAR 13
Flumist Quadrivalent
RotaTeq
ROTARIX
Sanofi Pasteur
Sanofi Pasteur
GlaxoSmithKline
Sanofi Pasteur
Sanofi Pasteur
GlaxoSmithKline
Fluzone Quadrivalent
Fluzone Quadrivalent
FLUARIX Quadrivalent
Fluzone Quadrivalent
Fluzone Quadrivalent
FLULAVAL
GlaxoSmithKline

KINRIX

# of Vaccine
Components
1
1
1
1
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4
6
sanofi pasteur
Pentacel
sanofi pasteur
GlaxoSmithKline
DAPTACEL
INFANRIX
5
3
CPT ®
Product
Code
Separately report the administration with codes 90460-90461 or 90471-90474
[Please see table below]
90702
Diphtheria and tetanus toxoids (DT), adsorbed when administered to younger than seven
years, for IM use
90707
Manufacturer
Brand
# of Vaccine
Components
sanofi pasteur
Diphtheria and Tetanus
Toxoids Adsorbed
2
Measles, mumps, and rubella virus vaccine (MMR), live, for subcutaneous use
Merck
M-M-R II
3
90710
Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
Merck
ProQuad
4
90713
Poliovirus vaccine (IPV), inactivated, for subcutaneous or IM use
sanofi pasteur
IPOL
1
90714
Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to seven
years or older, for IM use
sanofi pasteur
TENIVAC
2
Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to 7
years or older, for IM use
Varicella virus vaccine (VAR), live, for subcutaneous use
sanofi pasteur
GlaxoSmithKline
Merck
ADACEL
BOOSTRIX
VARIVAX
1
90723
Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and inactivated poliovirus
vaccine (DTaP-Hep B-IPV), for IM use
GlaxoSmithKline
PEDIARIX
5
90732
Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed
patient dosage, when administered to 2 years or older, for subcutaneous or IM use
Merck
PNEUMOVAX 23
1
sanofi pasteur
Menomune
1
sanofi pasteur
Novartis
Merck
Menactra
Menveo
RECOMBIVAX HB
Merck
RECOMBIVAX HB
Merck
GlaxoSmithKline
Merck
GlaxoSmithKline
GlaxoSmithKline
RECOMBIVAX HB
ENERGIX-B
RECOMBIVAX HB
ENERGIX-B
ENERGIX-B
90715
90716
3
90740
Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MenACWY
or MPSV4), for subcutaneous use
Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 quadrivalent (MenACWY or
MCV4) , for IM use
Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose, for IM use
90743
Hepatitis B vaccine (HepB), adolescent, 2 dose, for IM use
90744
Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose, for IM use
90746
Hepatitis B vaccine (HepB), adult dosage, for IM use
90747
Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose, for IM use
90748
Hepatitis B and Hib (Hep B-Hib), for IM use
Merck
COMVAX
2
90749
Unlisted vaccine or toxoid
Please
See CPT
Manual
90733
90734
90460
+90461
90471
+90472
90473
+90474
1
1
1
1
1
1
Immunization Administration (IA) Codes
IA Through Age 18 With Counseling^
IA 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 component administered (Do not report with 90471 or 90473)
IA through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid
component administered
Immunization Administration
IA, one injection (Do not report with 90460 or 90473)
IA, each additional injection
IA by intranasal/oral route; one vaccine (Do not report with 90460 or 90471)
IA by intranasal/oral route; each additional vaccine
On October 1, 2015 ICD-10-CM was implemented. Code Z23 is reported for all vaccine related encounters for all vaccines given. You will link both the CPT vaccine product code and the CPT vaccine
administration code to the Z23. Remember that the Z23 is also reported in addition to any health exam codes.
Vaccine pending FDA approval [http://www.ama-assn.org/ama/pub/category/10902.html]
+ Denotes add-on code. Report code only with appropriate primary procedure. Report 90461 with 90460 only. Report 90472 and 90473 in addition to 90460 or 90471 or 90473.
Developed and maintained by the American Academy of Pediatrics. For reporting purposes only.
CPT® Copyright 2015 American Medical Association. All rights reserved.