CPT code 90389 is used to identify the Tetanus immunoglobulin injection administered intramuscularly for patient treatment.
CPT code 90389 is used to describe the administration of tetanus immune globulin (TIG) via intramuscular injection. This code is typically utilized when a patient requires passive immunization against tetanus, often following an injury that poses a risk for tetanus infection, such as a deep cut or puncture wound. The immune globulin provides immediate, short-term protection by supplying antibodies that help neutralize the tetanus toxin. This code is important for healthcare providers to ensure accurate billing and reimbursement for the administration of this specific immunization service.
For CPT code 90389, which pertains to the administration of tetanus immune globulin intramuscularly, 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 evaluation and management service is performed by the same physician on the same day as the procedure.
2. Modifier 59: Distinct Procedural Service. This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if the tetanus immune globulin administration is performed in conjunction with other procedures that are not typically reported together.
3. Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional. This modifier is used if the tetanus 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 Health Care Professional. This modifier is used if the procedure is repeated on the same day by a different provider.
5. Modifier 91: Repeat Clinical Diagnostic Laboratory Test. Although not typically used for immunization codes, this modifier might be relevant if the administration is part of a diagnostic process requiring repetition.
6. Modifier 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System. This modifier is used if the service involves telemedicine, although it is less likely to be applicable for an intramuscular administration.
These modifiers help clarify the circumstances under which the tetanus immune globulin is administered and ensure accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 90389 is related to a specific immunization service. To determine if this code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the relevant Medicare Administrative Contractor (MAC) for your region. The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each MAC may have specific coverage determinations and policies that affect whether a particular CPT code is reimbursed.
For CPT code 90389, you would need to verify its status on the MPFS to see if it is listed and whether it has an assigned reimbursement rate. Additionally, checking with your local MAC will provide insights into any regional policies or coverage determinations that might influence reimbursement. It's important to note that Medicare coverage can vary based on factors such as medical necessity, patient eligibility, and specific local policies. Therefore, consulting these resources will provide the most accurate and up-to-date information regarding the reimbursement status of CPT code 90389.
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