CPT code 90710 is a unique identifier for the MMRV vaccine administered subcutaneously, used for tracking and documentation in healthcare.
CPT code 90710 is used to identify the administration of the Measles, Mumps, Rubella, and Varicella (MMRV) vaccine via subcutaneous injection. This code is utilized by healthcare providers to document and bill for the combined vaccine that protects against these four viral infections. The MMRV vaccine is typically administered to children to help prevent these diseases, which can lead to serious health complications. By using CPT code 90710, healthcare providers ensure accurate billing and reimbursement for the vaccine's administration as part of their revenue cycle management processes.
For CPT code 90710, which pertains to the administration of the MMRV 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 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 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 due to specific medical necessity.
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 the vaccine administration is part of a telehealth service where the provider is guiding the administration remotely.
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 for the services rendered. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 90710, which is associated with the MMRV vaccine, is not typically reimbursed by Medicare under the Medicare Physician Fee Schedule (MPFS). Medicare generally does not cover routine vaccinations for beneficiaries, except for certain preventive vaccines like influenza, pneumococcal, and hepatitis B for high-risk individuals. However, coverage can vary based on specific circumstances and the policies of the Medicare Administrative Contractor (MAC) in your region. It's essential for healthcare providers to verify coverage details with their local MAC to ensure accurate billing and reimbursement practices.
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