CPT Code Lookup Tool
Use this free CPT Lookup Tool to search for Current Procedural Terminology (CPT) codes, descriptions, and related details — designed to help streamline and simplify your medical billing process.
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Office or other outpatient visit
Evaluation and management of an established patient...
Information
This code is for use in medical billing and coding.
Information
This code is part of the section of CPT codes.
Office or other outpatient visit for the evaluation and management...
Note
This description reflects the 2021 E/M coding guidelines.
Information
codes are used to report evaluation and management services provided in various settings.
Information
RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
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This code is commonly used by primary care providers, but may be used by any specialty providing office visits.
Significant, separately identifiable E/M service
Information
Modifiers provide additional information about the service provided.
Detail About CPT 90681
Related Codes Table
| Code | Description |
|---|---|
| 90680 | Rotavirus vaccine, monovalent, live, for oral use |
| 90682 | Rotavirus vaccine, pentavalent, 2 dose schedule, live, for oral use |
| 90683 | Rotavirus vaccine, pentavalent, 3 dose schedule, live, for intramuscular use |
| 90684 | Rotavirus vaccine, pentavalent, 3 dose schedule, live, for subcutaneous use |
Commonly Billed With
CPT code 90681 is commonly billed with diagnosis codes such as Z23 (Encounter for immunization) and Z29.1 (Encounter for prophylactic vaccination and inoculation against other viral diseases).
Clinical Scenarios
Patient receives the first dose of rotavirus vaccine:
Assign CPT code 90681 for the administration of the first dose of the pentavalent rotavirus vaccine.
Patient completes the full 3-dose schedule:
Use CPT code 90681 for each administration of the pentavalent rotavirus vaccine until the patient completes the full 3-dose schedule.
Patient experiences an adverse reaction to the vaccine:
If a patient experiences an adverse reaction to the rotavirus vaccine, report the appropriate E/M code along with CPT code 90681.
Vaccine administered to an infant during a well-child visit:
For routine administration of the rotavirus vaccine during a well-child visit, report CPT code 90681 along with any applicable diagnosis codes.
FAQ
Can CPT code 90681 be reported for adults?
No, CPT code 90681 is specifically for pediatric patients receiving the pentavalent rotavirus vaccine.
Is prior authorization required for billing CPT code 90681?
Prior authorization requirements may vary by insurance carrier. It is recommended to check with the specific payer before administering the vaccine.
What documentation is necessary when billing CPT code 90681?
Documentation should include details of vaccine administration, dosage given, route of administration, and any adverse reactions observed.
Can CPT code 90681 be reported separately from an office visit?
Yes, CPT code 90681 can be reported separately if it is the only service provided during the encounter.
Are there specific age requirements for administering CPT code 90681?
CPT code 90681 is typically administered to infants between certain age ranges as recommended by healthcare guidelines. Check with healthcare authorities for specific age recommendations.
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