What is CPT® 90658?
CPT® 90658 is used to report the administration of an influenza virus vaccine, specifically a split virus, trivalent formulation, delivered via intramuscular (IM) injection. This code applies to flu vaccines designed to protect against three influenza virus strains: two influenza A strains and one influenza B strain.
When to Use CPT® 90658
This code should be reported when:
- A trivalent, inactivated influenza vaccine is administered intramuscularly.
- The vaccine type is split virus (most commonly used in standard seasonal influenza immunization).
- The service occurs during routine preventive care or seasonal flu campaigns.
Typical patient populations:
- Adults and children over 6 months who require protection from influenza during the flu season.
- Patients in high-risk groups, such as those with chronic conditions, pregnant women, and older adults.
Key Billing Information
- Product Code Only: CPT® 90658 covers the vaccine itself, not the administration.
- Administration Code: Bill separately using 90471 (initial immunization administration) or 90472 (each additional vaccine).
- ICD-10 Coding: Pair with appropriate diagnosis codes, such as Z23 (Encounter for immunization).
- Do Not Confuse With: Quadrivalent flu vaccines, which use different CPT® codes (e.g., 90686, 90688).
Documentation Requirements
- Vaccine type and brand name
- Lot number and expiration date
- Site and route of administration
- Patient consent and education provided
Why It Matters
Proper coding for influenza vaccines like 90658 ensures compliance with payer requirements and accurate reimbursement for preventive services. Missing or incorrect vaccine codes can lead to claim denials and revenue loss, especially during high-volume flu seasons.
How OptiMantra Streamlines Vaccine Management
OptiMantra simplifies vaccine administration and billing with:
- Integrated vaccine inventory tracking with alerts for low stock and expirations
- Preloaded CPT® and ICD-10 codes for flu shots and other immunizations
- Automated superbill generation for both product and administration codes
- Patient reminders and online scheduling to boost vaccination rates
- Compliance-ready documentation templates for vaccine logs and consent
By using OptiMantra, practices can efficiently manage flu vaccination campaigns, eliminate billing errors, and keep patients protected, all while saving time for staff and improving cash flow.
Try OptiMantra for free here!
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