CPT code 90682 is a code used to identify the Riv4 vaccine, which is administered via recombinant DNA injection.
CPT code 90682 is used to identify the administration of the recombinant influenza vaccine, specifically the quadrivalent type, which is produced using recombinant DNA technology. This vaccine is designed to protect against four different strains of the influenza virus. The code is utilized by healthcare providers to document and bill for the administration of this particular type of flu vaccine, ensuring accurate reimbursement and record-keeping within the healthcare revenue cycle.
For CPT code 90682, which pertains to the administration of a recombinant DNA influenza vaccine, the following modifiers may be applicable:
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 an additional, distinct service during the same visit.
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 multiple vaccines are administered and need to be distinguished from one another.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified healthcare professional. This modifier is used if the vaccine needs to be administered more than once on the same day due to specific medical circumstances.
4. Modifier 77: Repeat procedure by another physician or other qualified healthcare 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. While not typically applicable to vaccine administration, this modifier could be relevant if the vaccine administration is part of a telehealth consultation.
6. Modifier 99: Multiple modifiers. This is used when two or more modifiers are necessary to describe the service provided accurately.
These modifiers ensure that the billing for the vaccine administration is accurate and reflects the specific circumstances under which the service was provided. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
The CPT code 90682 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the actual reimbursement for CPT code 90682 can vary based on the geographic location and the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in that region. Each MAC has the authority to interpret national Medicare policies and apply them to local circumstances, which can affect the reimbursement process. Therefore, healthcare providers should consult their local MAC for detailed information on the reimbursement criteria and rates applicable to CPT code 90682.
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