CPT code 90584 is used to identify the administration of the dengue vaccine, specifically the two-dose subcutaneous version.
CPT code 90584 is used to identify the administration of a dengue vaccine, specifically a quadrivalent (four-strain) vaccine that is given in a two-dose series via subcutaneous injection. This code is utilized by healthcare providers to document and bill for the vaccination procedure, ensuring accurate tracking and reimbursement for the service provided.
For CPT code 90584, which pertains to the administration of the dengue vaccine, the following modifiers may be applicable depending on the specific circumstances of the service provided:
1. Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service. Use this modifier if a significant, separately identifiable evaluation and management service is performed by the same provider on the same day as the vaccine administration.
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 applicable if the vaccine 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. Use this modifier if the dengue vaccine is 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 dengue vaccine is administered more than once on the same day by a different provider.
5. Modifier 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System. Although not typically applicable to vaccine administration, if any part of the service involves telemedicine, this modifier may be relevant.
6. Modifier 99: Multiple Modifiers. Use this modifier when two or more modifiers are necessary to describe the service provided.
These modifiers should be used in accordance with payer guidelines and the specific clinical scenario to ensure accurate billing and reimbursement. Always verify with the latest coding guidelines and payer policies, as these can change over time.
CPT code 90584, which pertains to a specific medical service, is not reimbursed by Medicare. The Medicare Physician Fee Schedule (MPFS) does not list this code, indicating that it is not covered under standard Medicare reimbursement policies.
Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing Medicare claims and determining coverage at a regional level, typically follow the guidelines set forth by the MPFS. Therefore, healthcare providers should be aware that claims submitted to Medicare for CPT code 90584 are unlikely to be reimbursed.
It is advisable for providers to verify coverage specifics with their local MAC to ensure compliance and accurate billing practices.
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