CPT code 90376 is a specific code used to identify the rabies immunoglobulin that has been heat treated for medical procedures.
CPT code 90376 is used to describe the administration of rabies immune globulin that has been heat-treated. This code is specifically for the immune globulin product that has undergone a heat treatment process to inactivate potential viruses, ensuring safety and efficacy. It is typically used in post-exposure prophylaxis to prevent rabies infection after a potential exposure, such as an animal bite. This code is important for healthcare providers to accurately document and bill for the administration of this specific type of rabies immune globulin.
For CPT code 90376, which pertains to Rabies immune globulin, heat-treated, 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 when a significant, separately identifiable E/M service is performed by the same physician on the same day as the administration of the rabies immune globulin.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that the administration of the rabies 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 rabies immune globulin needs to be administered more than once 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 rabies immune globulin is administered more than once on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. Although not typically applicable to drug administration, this modifier could be used if the administration is part of a repeated diagnostic test scenario.
6. Modifier 99: Multiple modifiers. This is used when two or more modifiers are necessary to describe the service provided.
These modifiers help ensure accurate billing and reimbursement by providing additional context for the services rendered. Always verify with the latest coding guidelines and payer-specific requirements to ensure proper usage.
CPT code 90376, which pertains to Rabies immune globulin, heat-treated, is subject to reimbursement considerations under Medicare. To determine if this specific CPT code is reimbursed by Medicare, healthcare providers should consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and procedures covered by Medicare, along with their respective reimbursement rates.
Additionally, it's important to note that Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide guidance on coverage and payment policies specific to their jurisdiction. Since coverage can vary based on local policies and interpretations, providers should verify with their respective MAC to confirm if CPT code 90376 is reimbursed and under what conditions.
In summary, while the MPFS is a primary resource for determining Medicare reimbursement, consulting with the appropriate MAC is essential for the most accurate and localized information regarding the reimbursement of CPT code 90376.
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