CPT code 90715: Tdap Vaccine (Tetanus, Diphtheria, and Pertussis)

Acquire information on CPT code 90715, the code on administering the Tdap vaccine, its requirements and guidelines. ‍

What is the 90715 CPT code?

CPT 90715, a primary procedure code in vaccine administration, is used by healthcare providers when administering tetanus, diphtheria, and acellular pertussis (Tdap) vaccines to individuals aged 7 years and older.

The said vaccine is preservative-free and has a reduced dose of tetanus toxoids, diphtheria toxoids, and acellular pertussis components. It is typically administered by a qualified healthcare professional via intramuscular injection to adolescents and its booster to adults, specifically pregnant women.

Documentation requirements

To ensure the accuracy of the services rendered, it's best that the qualified healthcare professional who administered the vaccine document the following, preferably on the same date of immunization administration:

Patient identification, specifically the patient's name, date of birth, clinical indication, and medical history, including any allergies, contraindications, or previous reactions to vaccines

Patient's informed consent
Name and title of who administered the vaccine
Medical necessity
Date of administration
Vaccine name, lot number, manufacturer expiration date, dosage
Injection site and route (IM)
Adverse reactions of complications observed

Billing guidelines

To reduce coding errors and potential delays in claim processing, the healthcare provider must keep the following billing guidelines in mind:

Use the code for individuals aged 7 years and older and a separate code for administration.
Verify the specific payer's billing requirements and coverage policies.
Confirm eligibility and coverage under preventive benefits or other specific types. For example, the code doesn't fall under Medicare Part B unless it is to treat an injury. Rather, it falls under Medicare Part D.
Has the appropriate ICD-10 diagnosis code to indicate the reason for vaccination.
Provide modifiers if needed.

Do note that other vaccines to be administered have other codes and must be listed separately.

Frequently asked questions

The physician or other qualified health care professional generally administers the Tdap vaccine once in adulthood, but boosters are recommended every 10 years thereafter unless otherwise indicated.

Yes, the Centers for Disease Control recommends it between 27–36 weeks gestation.

Often, yes, when given as part of routine immunization.