CPT code 90377 is a specific code used to identify the rabies immunoglobulin treatment administered to humans via injection.
CPT code 90377 is used to describe the administration of rabies immune globulin, human, for intramuscular or subcutaneous use. This code is specifically utilized when billing for the provision of rabies immune globulin, which is a critical component in the post-exposure prophylaxis for individuals who have been potentially exposed to the rabies virus. The immune globulin provides immediate passive immunity by supplying antibodies that help neutralize the virus, offering protection until the patient's own immune system can respond to the rabies vaccine. This code is essential for healthcare providers to accurately document and bill for the administration of this life-saving treatment.
For CPT code 90377, which pertains to the administration of rabies immune globulin, human, for intramuscular or subcutaneous use, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure or other service. This modifier is used when an E/M service is provided on the same day as the administration of the rabies immune globulin, and the E/M service is distinct and separate from the procedure.
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. It is typically used to prevent bundling of services that are usually considered part of a single procedure.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified healthcare professional. This modifier is used if the rabies immune globulin administration needs to be repeated on the same day by the same provider.
4. Modifier 77: Repeat procedure by another physician or other qualified healthcare professional. This modifier is used if the rabies 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 applicable if the administration is part of a diagnostic test that needs to be repeated for clinical reasons.
These modifiers help clarify the circumstances under which the rabies immune globulin is administered and ensure appropriate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
The CPT code 90377 is associated with the administration of rabies immune globulin, human, for intramuscular or subcutaneous use. To determine if this specific CPT code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the relevant Medicare Administrative Contractor (MAC) guidelines.
The MPFS provides a comprehensive list of services covered by Medicare, along with their respective reimbursement rates. However, coverage can vary based on the local policies set by each MAC, which administers Medicare claims for specific regions. MACs have the authority to establish Local Coverage Determinations (LCDs) that specify whether a particular service is covered and under what circumstances.
For CPT code 90377, healthcare providers should verify its inclusion in the MPFS and review any applicable LCDs from their regional MAC to confirm coverage and reimbursement details. This ensures compliance with Medicare's billing requirements and helps optimize revenue cycle management for healthcare providers.
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