CPT code 90708 is a specific code used to identify the measles-rubella vaccine administered via subcutaneous injection.
CPT code 90708 is used to identify the administration of the measles-rubella vaccine via subcutaneous injection. This code is specifically designated for the combination vaccine that provides immunization against both measles and rubella, two highly contagious viral infections. The use of this code is crucial for healthcare providers to accurately document and bill for the vaccine administration, ensuring proper reimbursement and maintaining precise patient immunization records.
For CPT code 90708, which pertains to the administration of the measles-rubella vaccine 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 patient receives an evaluation and management (E/M) service on the same day as the vaccine administration, and the E/M service is distinct and separate from 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 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 same vaccine is administered more than once on the same day by the same provider, which is uncommon but possible in certain clinical scenarios.
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 typically applicable to vaccine administration, this modifier might be used if there is a telehealth consultation related to the vaccine administration.
6. Modifier SL: State-supplied vaccine. This modifier is used when the vaccine is provided to the healthcare provider at no cost by the state.
These modifiers help ensure accurate billing and reimbursement by providing additional context to the services rendered. It's important to verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 90708, which is associated with the measles-rubella vaccine administered subcutaneously, is generally not reimbursed by Medicare. Medicare typically does not cover routine immunizations, including vaccines like the measles-rubella vaccine, unless they are directly related to the treatment of an injury or direct exposure to a disease or condition.
The Medicare Physician Fee Schedule (MPFS) does not list CPT code 90708 for reimbursement, as it primarily focuses on services that are considered medically necessary for the diagnosis or treatment of illness or injury. Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing claims and determining coverage specifics, follow these guidelines and do not provide reimbursement for this particular vaccine under standard circumstances. Healthcare providers should verify with their specific MAC for any exceptions or updates to coverage policies.
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