90715

Tetanus, Diphtheria Toxoids, and Acellular Pertussis Vaccine (Tdap), 7 Years or Older, IM

CPT code 90715 describes the product for the Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Tdap) vaccine, which is specifically formulated for individuals aged seven years and older. This combination vaccine is essential for preventing three distinct and potentially fatal bacterial infections. Tetanus, commonly known as lockjaw, is caused by toxins produced by the bacterium Clostridium tetani, which usually enters the body through contaminated wounds or punctures, leading to severe muscle spasms, autonomic instability, and potentially respiratory failure. Diphtheria is an upper respiratory tract illness caused by Corynebacterium diphtheriae, characterized by a thick pseudomembrane in the throat that can cause airway obstruction and systemic organ damage via toxin release. Pertussis, or whooping cough, is a highly contagious respiratory infection caused by Bordetella pertussis, which can lead to severe coughing fits and is particularly dangerous for infants. Unlike the DTaP vaccine administered to younger children, the Tdap vaccine (90715) contains reduced amounts of diphtheria toxoid and pertussis antigens. The clinical procedure associated with this code involves the preparation and intramuscular administration of the vaccine, typically into the deltoid muscle. The vaccine is supplied as a sterile suspension in a single-dose vial or prefilled syringe. Before administration, the healthcare provider must screen the patient for contraindications, such as a history of severe allergic reactions (anaphylaxis) to previous doses or vaccine components, or a history of encephalopathy within seven days of a previous pertussis-containing vaccine. Clinical documentation of the vaccine administration is critical, encompassing the manufacturer, lot number, expiration date, dosage, site of injection, and the date the Vaccine Information Statement (VIS) was provided. This code represents the vaccine product only; the physical administration and any associated counseling are reported using separate administration codes.

Clinical Indications

  • Routine adolescent booster dose at age 11-12 years
  • Decennial (every 10 years) booster for adults
  • Tetanus prophylaxis in wound management for individuals who have not received a Tdap booster within the last 5 to 10 years
  • Pregnant women during each pregnancy, ideally between 27 and 36 weeks of gestation
  • Healthcare personnel with direct patient contact
  • Catch-up immunization for adults and children 7 years and older with incomplete primary series
  • Close contacts of infants under 12 months of age (cocooning)

Procedure Steps

  1. Verify patient identity and age (must be 7 years or older).
  2. Review medical history for contraindications including prior anaphylaxis, Arthus-type hypersensitivity, or unstable neurologic conditions.
  3. Provide the current Tdap Vaccine Information Statement (VIS) to the patient or guardian and record the edition date.
  4. Inspect the vaccine for particulate matter or discoloration prior to administration.
  5. Cleanse the injection site, typically the deltoid muscle, with an antiseptic swab.
  6. Administer the vaccine intramuscularly (IM) at a 90-degree angle into the muscle tissue.
  7. Withdraw the needle and apply gentle pressure; dispose of the syringe in a biohazardous sharps container.
  8. Monitor the patient for at least 15 minutes post-injection for signs of syncope or immediate allergic reaction.
  9. Record the manufacturer, lot number, expiration date, injection site, and administrator's name in the medical record.

Coding Guidelines

  • 90715 represents the vaccine product only. It must be reported in conjunction with an immunization administration code (e.g., 90460, 90461, 90471, or 90472).
  • Do not report 90715 for children younger than 7 years of age; use the appropriate DTaP vaccine code (e.g., 90700).
  • Use 90714 when administering a Tetanus and Diphtheria (Td) vaccine that does not include the pertussis component.
  • When a significant, separately identifiable Evaluation and Management (E/M) service is performed at the same visit as the immunization, append modifier 25 to the E/M code.
  • Medicare coverage for Tdap may fall under Part D unless administered for injury/wound management (Part B), so check specific payer policies.
  • Always document the specific components of counseling if using codes 90460-90461 for patients 18 years and younger.

Associated ICD-10 Codes