Current Procedural Terminology (CPT) codes are the standardized, five-digit language healthcare providers use to describe medical services and procedures for billing and reporting. These codes ensure consistent communication and accurate documentation across providers, payers, and government agencies. CPT 90715 represents a prophylactic immunization product tracked within this system.
Defining CPT 90715
CPT code 90715 is specifically designated for the Tetanus, Diphtheria, and Acellular Pertussis (Tdap) vaccine. This code identifies the vaccine product itself, a combination toxoid administered via intramuscular injection. It is distinct from the codes used for the administration, functioning solely to track the cost and inventory of the substance.
CPT 90715 is intended for individuals seven years of age or older. The Tdap vaccine differs from the DTaP (Diphtheria, Tetanus, and acellular Pertussis) vaccine, which uses a higher concentration of components for children typically under seven years of age. CPT 90715 serves as the standard identifier for the adolescent and adult formulation, which provides protection against pertussis that tends to fade following childhood vaccination.
Clinical Application and Eligibility Parameters
CPT 90715 is used in various clinical settings, reflecting the need for Tdap booster shots across the lifespan. Eligibility begins at seven years of age, marking the transition from the pediatric DTaP series to the Tdap booster. The code’s application is particularly important in specific, high-priority populations.
A primary application is maternal immunization, where Tdap is recommended during every pregnancy, regardless of prior vaccination history. Providers typically administer the vaccine between 27 and 36 weeks of gestation. This timing maximizes the transfer of protective antibodies from the pregnant person to the fetus before birth.
This process creates temporary, passive immunity in the newborn, offering protection against pertussis during the first two months of life. Infants are most vulnerable to severe complications from whooping cough during this early period, as they are too young for their own DTaP vaccine series. The vaccine is also frequently administered to healthcare personnel (HCP), especially those who work closely with infants or pregnant people. HCP should receive a single dose of Tdap if they have not had one previously, followed by Td boosters every ten years.
Documentation and Administration Code Requirements
Billing for Tdap immunization requires a two-part approach. Since 90715 is only the product code for the vaccine substance, it must be paired with a separate administration code that covers the clinical service of giving the injection.
Administration Codes
For patients 19 years and older, administration is typically reported using CPT 90471 for the first vaccine administered. If Tdap is given alongside another injection, CPT 90472 is used for the second and any subsequent vaccines.
For patients 18 years of age and under, CPT 90460 and CPT 90461 are used if a qualified professional provides face-to-face counseling on the vaccine. Code 90460 is used for the first vaccine component, and the add-on code 90461 is used for each additional component of the combined vaccine, such as the three components in Tdap. This set of codes reflects the added time involved in counseling minors and their caregivers.
Documentation Requirements
Accurate documentation is mandated for all immunizations to ensure patient safety and proper tracking. The patient’s record must include several specific details:
- The vaccine manufacturer and specific lot number.
- The exact date of administration.
- The name and title of the healthcare professional who administered the vaccine.
- The route of administration, which is intramuscular (IM) for the Tdap vaccine.
If the vaccine is given during a separate Evaluation and Management (E/M) visit, a modifier like modifier 25 may be added to the E/M code to indicate the visit was distinct from the immunization service.