CPT code 90622 is a code used to identify the Vaccinia virus vaccine, specifically for a 0.3 ml percutaneous administration.
CPT code 90622 is used to describe the administration of the vaccinia virus vaccine, specifically in a 0.3 ml percutaneous dosage. This vaccine is typically used for immunization against smallpox. The code is utilized by healthcare providers to document and bill for the delivery of this specific vaccine to patients, ensuring accurate tracking and reimbursement for the service provided.
For CPT code 90622, which pertains to the administration of the vaccinia virus 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 in addition to 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 vaccine 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 vaccine administration is repeated on the same day by a different provider.
5. Modifier 91: Repeat Clinical Diagnostic Laboratory Test. Although not typically used for vaccine administration, this modifier may be applicable if the vaccine administration is part of a clinical diagnostic test that needs to be repeated.
6. Modifier 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System. Use this modifier if the vaccine administration is part of a telemedicine service.
These modifiers should be used based on the specific context of the service provided and in accordance with payer guidelines. Always ensure proper documentation to support the use of any modifier.
CPT code 90622, which is associated with a specific medical service, is subject to reimbursement by Medicare, but this depends on several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that determines whether a particular CPT code is reimbursable and at what rate. To ascertain if CPT code 90622 is reimbursed, healthcare providers should consult the MPFS to verify its inclusion and the associated reimbursement rate.
Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide guidance on coverage policies that may affect the reimbursement of CPT code 90622. Providers should check with their local MAC to ensure that the service associated with this code meets the necessary criteria for reimbursement under Medicare guidelines. It is also advisable to stay updated on any changes to Medicare policies that could impact the reimbursement status of this code.
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