CPT code 90676 is a specific code used to identify the rabies vaccine administered via injection.
CPT code 90676 is used to identify the administration of the rabies vaccine given intradermally. This code is specifically utilized by healthcare providers to document and bill for the preventive vaccination against rabies, a viral disease that can be transmitted to humans through the bite of an infected animal. The intradermal route involves injecting the vaccine into the skin rather than into the muscle, which can be a more cost-effective method in certain scenarios. Proper use of this code ensures accurate billing and reimbursement for the vaccination service provided.
For CPT code 90676, which pertains to the rabies vaccine administered intradermally, 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 or other qualified healthcare professional on the same day of the procedure or other service. This modifier is used when a patient receives a vaccine and also has a separate evaluation and management service on the same day.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that the vaccine administration is distinct or independent from other services performed on the same day.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified healthcare professional. This modifier is used if the rabies 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 healthcare professional. This modifier is used if the rabies vaccine is administered more than once on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. Although not typically used for vaccines, if the administration of the vaccine is part of a clinical study or trial requiring repeated administration for testing purposes, this modifier might be applicable.
6. 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 direct administration typically requires in-person interaction.
These modifiers help clarify the circumstances under which the rabies vaccine is administered and ensure accurate billing and reimbursement. It is important to review payer-specific guidelines as they may have additional requirements or restrictions regarding the use of modifiers.
CPT code 90676, which pertains to a specific medical service, is not reimbursed by Medicare. When determining whether a particular CPT code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the Medicare Administrative Contractor (MAC) for your region.
The MPFS outlines the payment rates for services covered under Medicare Part B, while the MACs are responsible for processing Medicare claims and providing guidance on coverage and reimbursement policies.
In the case of CPT code 90676, it is not listed on the MPFS as a reimbursable service, indicating that Medicare does not provide reimbursement for this code. Healthcare providers should verify with their local MAC for any updates or specific regional policies that might affect reimbursement.
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