2025 CPT code 90685
(Active) Effective Date: N/A Revision Date: N/A Medicine - Vaccines, Toxoids Medicine Services and Procedures Feed
Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative-free, 0.25 mL dosage, for intramuscular use.
Modifier 51 is not permitted. Other modifiers may apply depending on the circumstances of service; refer to the CPT manual for guidance on modifier use.
Medical necessity is established through documentation that the patient is at risk for influenza and that vaccination is appropriate.This may include age, medical conditions, occupation, or exposure to others who are at higher risk for severe influenza complications.
The provider's responsibility includes reviewing immunization options with the patient/guardian, explaining risks/benefits and side effects, providing instructions and precautions, administering the intramuscular injection of the vaccine, and documenting the procedure.
In simple words: This code is for a specific type of flu shot. It's a four-strain flu vaccine given as a shot in the muscle.The shot doesn't have preservatives in it.
This CPT code, 90685, represents the administration of a quadrivalent influenza virus vaccine (IIV4).The vaccine is a split virus formulation, meaning it contains purified viral components rather than whole viruses. It is preservative-free and comes in a 0.25 mL intramuscular dose.This code is used to bill for the vaccine itself, not the administration.An additional code is needed to report vaccine administration (e.g., 90460, 90461, 90471-90474 or 90480 for COVID-19 vaccines).
Example 1: A 65-year-old patient receives a quadrivalent, preservative-free influenza vaccine (90685) during a routine annual checkup in the physician's office.The administration would be coded separately (e.g., 90460). , A pediatrician administers a 0.25 mL dose of the quadrivalent influenza vaccine to a 2-year-old child.The administration is billed with the appropriate administration code and the 90685 code for the vaccine., A patient receives both a quadrivalent flu vaccine (90685) and another vaccine (e.g., pneumococcal) during the same visit. The administration codes for both vaccines should be reported, along with both vaccine product codes.
Documentation should include the type of vaccine administered (quadrivalent influenza, split virus, preservative-free), the dose (0.25 mL), the route of administration (intramuscular), the date of administration, and any adverse reactions. Patient's age, medical history and reason for vaccination should also be documented.
** The vaccine abbreviations used in CPT codes reflect ACIP recommendations at the time of publication.Interim updates are made on the AMA CPT website.
- Revenue Code: O1G (Influenza Immunization)
- RVU: This information is not provided in the source.
- Global Days : Not applicable to this vaccine code.
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable to this vaccine code.
- Fee Schedule : This information is not available in the source data.
- Specialties:Family Medicine, Internal Medicine, Pediatrics, Geriatrics, Occupational Medicine
- Place of Service:Office, Clinic, Hospital, Other