CPT code 90714 is a code used to identify the Td vaccine for individuals aged 7 years and older administered via injection.
CPT code 90714 is used to identify the administration of the tetanus and diphtheria (Td) vaccine without preservatives for individuals aged 7 years and older, given via intramuscular injection. This code is utilized by healthcare providers to document and bill for the specific service of administering this vaccine, ensuring that the patient receives protection against these two serious bacterial infections.
For CPT code 90714, which pertains to the administration of the Td vaccine without preservatives for individuals aged 7 years and older 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 typically applicable to vaccine administration, this modifier might be relevant if there is a telehealth component involved in the service.
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 is important to verify payer-specific guidelines, as modifier requirements can vary.
CPT code 90714 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines. The Medicare Physician Fee Schedule (MPFS) provides the framework for determining the reimbursement rates for services covered under Medicare Part B, including vaccinations. However, the actual reimbursement for CPT code 90714 can vary based on the region and the specific Medicare Administrative Contractor (MAC) responsible for processing claims in that area. Each MAC may have its own local coverage determinations (LCDs) that can affect whether and how a particular service is reimbursed. Therefore, healthcare providers should consult the MPFS and their respective MAC's guidelines to ensure compliance and accurate reimbursement for CPT code 90714.
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