CPT code 90371 is a code used to identify the administration of Hepatitis B immune globulin, helping streamline healthcare documentation and reimbursement.
CPT code 90371 is used to describe the administration of hepatitis B immune globulin (Hep B IG) via intramuscular injection. This code is specifically utilized when a patient requires passive immunization against hepatitis B, often following potential exposure to the virus. The immune globulin provides immediate, short-term protection by supplying antibodies that help prevent the infection from taking hold. This code is crucial for healthcare providers to ensure accurate billing and documentation of the immunization service provided.
For CPT code 90371, which pertains to the administration of Hepatitis B immune globulin, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. This modifier is used if the administration of the Hepatitis B immune globulin is performed on the same day as a significant and separately identifiable evaluation and management service.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that the administration of the Hepatitis B immune globulin is distinct or independent from other services performed on the same day.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used if the Hepatitis B immune globulin administration is repeated on the same day by the same provider.
4. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used if the Hepatitis B immune globulin administration is repeated on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. Although not typically used for immunoglobulin administration, this modifier might be relevant if the administration is part of a repeated diagnostic test scenario.
6. Modifier 22: Increased procedural services. This modifier is used if the administration of the Hepatitis B immune globulin required significantly more work than typically required.
Each of these modifiers serves a specific purpose and should be used in accordance with the specific circumstances of the service provided to ensure accurate billing and reimbursement.
CPT code 90371 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a comprehensive list of services and their corresponding reimbursement rates, but not all CPT codes are covered or reimbursed at the same rate.
Additionally, MACs have the authority to make determinations on coverage and reimbursement for services within their jurisdiction, which can lead to variations in how CPT code 90371 is reimbursed across different regions.
Therefore, healthcare providers should consult the MPFS and their local MAC to determine the specific reimbursement status and requirements for CPT code 90371.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 90371, RevFind provides unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and optimize your financial outcomes.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
