CPT code 90717 is a code used to identify the yellow fever vaccine administered subcutaneously in healthcare settings.
CPT code 90717 is used to identify the administration of the yellow fever vaccine via subcutaneous injection. This code is utilized by healthcare providers to document and bill for the immunization service provided to patients who require protection against yellow fever, a viral infection transmitted by mosquitoes. The use of this code ensures accurate tracking and reimbursement for the vaccination service within the healthcare revenue cycle.
For CPT code 90717, which pertains to the administration of the yellow fever 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 a vaccine and also has a separate evaluation and management service on the same day.
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 vaccine administration is repeated 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 administration is repeated on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. Although not typically used for vaccines, this modifier may be applicable if the vaccine administration is part of a series of tests or procedures that need to be repeated for clinical reasons.
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 90717, which is associated with the yellow fever vaccine administered subcutaneously, is generally not reimbursed by Medicare. This is because Medicare typically does not cover routine immunizations, including travel vaccines like the yellow fever 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) outlines the services and procedures that are covered and reimbursed by Medicare, and preventive vaccines such as the yellow fever vaccine are not included in this schedule for reimbursement. Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing Medicare claims and determining coverage at the local level, follow these guidelines and do not provide reimbursement for CPT code 90717 under standard circumstances. Healthcare providers should verify coverage specifics with their local MAC to ensure compliance and accurate billing practices.
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