CPT code 90674 is a specific code used to identify the administration of the Cciiv4 vaccine, ensuring accurate documentation and reporting in healthcare.
CPT code 90674 is used to identify the administration of the influenza vaccine, specifically the quadrivalent formulation without preservatives, delivered in a 0.5 mL dosage via intramuscular injection. This code is utilized by healthcare providers to document and bill for the service of administering this particular type of flu vaccine, which is designed to protect against four different flu viruses. The absence of preservatives makes it a suitable option for individuals who may have sensitivities or allergies to such additives.
For CPT code 90674, which pertains to the administration of a preservative-free vaccine, 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 (E/M) service is performed by the same physician 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. This modifier is used if the 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 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. This modifier is used if the vaccine administration is part of a telemedicine service, although this is less common for vaccine administration.
6. Modifier SL: State Supplied Vaccine. This modifier is used when the vaccine is supplied by the state, indicating that the provider did not incur the cost of the vaccine.
These modifiers help ensure accurate billing and reimbursement by providing additional context for the services rendered. It is important to verify payer-specific guidelines, as the applicability of modifiers can vary.
The CPT code 90674 is reimbursed by Medicare, but its reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates. However, the actual reimbursement for CPT code 90674 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national Medicare policies and make decisions regarding coverage and payment for services within their jurisdiction. Therefore, healthcare providers should consult their local MAC for precise information on the reimbursement of CPT code 90674.
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