CPT code 90690 is a specific code used to identify the oral typhoid vaccine for healthcare providers in documentation and reporting.
CPT code 90690 is used to identify the administration of the oral typhoid vaccine. This code is utilized by healthcare providers to document and bill for the provision of this specific vaccine, which is used to prevent typhoid fever, a bacterial infection caused by Salmonella typhi. The oral typhoid vaccine is typically administered to individuals traveling to areas where typhoid fever is prevalent, and this code helps ensure accurate tracking and reimbursement for the vaccine's administration within the healthcare revenue cycle.
For CPT code 90690, which pertains to the typhoid vaccine oral, 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 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 counseling or administration is part of a telemedicine service.
6. Modifier 99: Multiple Modifiers. This modifier is used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the vaccine was administered, ensuring accurate billing and reimbursement. Always verify with current payer policies and guidelines, as requirements can vary.
CPT code 90690, which is associated with the typhoid vaccine oral, is not reimbursed by Medicare. According to the Medicare Physician Fee Schedule (MPFS), certain preventive services, including some vaccines, may not be covered under Medicare Part B. Coverage for vaccines under Medicare is typically limited to those that are explicitly included in the preventive services list, such as influenza, pneumococcal, and hepatitis B vaccines for high-risk individuals.
Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing claims and determining local coverage decisions, do not generally provide reimbursement for CPT code 90690. Providers should verify with their specific MAC for any updates or changes in coverage policies, as these can vary by region and may be subject to periodic revisions.
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