CPT code 90704 is a specific code used to identify the mumps vaccine administered via subcutaneous injection in healthcare documentation.
CPT code 90704 is used to identify the administration of the mumps vaccine via subcutaneous injection. This code is specifically designated for billing purposes when a healthcare provider administers the mumps vaccine to a patient. It is important for accurate documentation and reimbursement in the healthcare revenue cycle, ensuring that the provider is compensated for the vaccine administration service.
For CPT code 90704, which pertains to the mumps vaccine administered subcutaneously, 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 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 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 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 rare for vaccine administration.
6. Modifier SL: State-supplied vaccine. This modifier is used when the vaccine is supplied by the state for administration.
These modifiers help clarify the circumstances under which the vaccine is administered and ensure accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 90704, which is associated with the mumps vaccine administered subcutaneously, is not reimbursed by Medicare. The Medicare Physician Fee Schedule (MPFS) does not include this code for reimbursement because Medicare typically does not cover vaccines that are not directly related to the prevention of influenza, pneumococcal infections, or hepatitis B for high-risk individuals.
Additionally, Medicare Administrative Contractors (MACs) follow the guidelines set forth by the Centers for Medicare & Medicaid Services (CMS), which do not provide coverage for routine immunizations like the mumps vaccine under Part B. Therefore, healthcare providers should be aware that they will not receive reimbursement from Medicare for administering this particular vaccine.
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