CPT code 90706 is a specific code used to identify the rubella vaccine administered via subcutaneous injection.
CPT code 90706 is used to identify the administration of the rubella vaccine via subcutaneous injection. This code is specifically designated for billing purposes when a healthcare provider administers the rubella vaccine to a patient. The rubella vaccine is crucial for preventing rubella, a contagious viral infection that can have serious health implications, particularly for pregnant women and their unborn children. By using this code, healthcare providers can accurately document and bill for the vaccine administration as part of their revenue cycle management processes.
For CPT code 90706, which pertains to the administration of the rubella vaccine subcutaneously, 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 if 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 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 91: Repeat clinical diagnostic laboratory test. Although typically used for lab tests, this modifier can be relevant if the vaccine administration is repeated for clinical reasons.
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 vaccine is administered and ensure accurate billing and reimbursement. Always verify payer-specific guidelines, as modifier usage can vary.
CPT code 90706 is associated with the administration of the rubella vaccine. When it comes to Medicare reimbursement, it's important to note that Medicare typically does not cover routine vaccinations like the rubella vaccine, as these are generally covered under preventive services for children and certain adults through other programs, such as Medicaid or private insurance plans.
The Medicare Physician Fee Schedule (MPFS) outlines the services that are reimbursable under Medicare Part B, and routine vaccines like the rubella vaccine are not typically included. Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing Medicare claims, follow the guidelines set forth by the MPFS. Therefore, CPT code 90706 is not reimbursed by Medicare. Healthcare providers should verify coverage specifics with their MAC and consider alternative billing options for patients who may require this vaccine.
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