CPT code 90702 is a code used to identify the administration of the DT vaccine for children under 7 years old.
CPT code 90702 is used to identify the administration of the diphtheria and tetanus toxoids (DT) vaccine for children under 7 years of age, given via intramuscular injection. This code is specifically utilized by healthcare providers to document and bill for the immunization service provided to young patients, ensuring they receive protection against these serious bacterial infections.
For CPT code 90702, which pertains to the administration of the Diphtheria and Tetanus (DT) vaccine for children under 7 years of age via intramuscular injection, 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 significant, separately identifiable E/M 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 the same physician or other qualified healthcare professional. This modifier is used if the same 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 same 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 commonly used for vaccine administration, this modifier may be applicable if the service involves telehealth components.
6. Modifier SL: State-supplied vaccine. This modifier is used when the vaccine is supplied by the state and not billed to the patient or insurance.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. It is important to review payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 90702, which is associated with the administration of a specific vaccine, is generally reimbursed by Medicare under certain conditions. To determine if this code is reimbursed, healthcare providers should consult the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered by Medicare.
Additionally, reimbursement can vary based on the specific Medicare Administrative Contractor (MAC) that processes claims in a provider's region, as MACs have the authority to make local coverage determinations. Providers should verify with their respective MAC to ensure that CPT code 90702 is covered and to understand any specific billing requirements or limitations that may apply.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 90702, RevFind provides unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and safeguard your practice's financial health.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
