CPT code 90725 is a code used to identify the injectable cholera vaccine for healthcare services and procedures.
CPT code 90725 is used to identify the administration of the cholera vaccine in an injectable form. This code is utilized by healthcare providers to document and bill for the service of providing this specific vaccine to patients. The cholera vaccine is typically administered to individuals who are traveling to areas where cholera is prevalent or during outbreaks to prevent the disease. By using CPT code 90725, healthcare providers ensure accurate billing and record-keeping for the vaccination service rendered.
For CPT code 90725, which pertains to the cholera vaccine injectable, the following modifiers may be applicable depending on the specific circumstances of the service provided:
1. Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service. Use this modifier if a significant, separately identifiable evaluation and management service is performed by the same physician on the same day as 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 a different session or encounter.
3. Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional. Use this modifier if the cholera 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 cholera 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. Although not typically applicable to vaccine administration, if the service involves telemedicine components, this modifier might be relevant.
6. Modifier 99: Multiple Modifiers. Use this modifier when two or more modifiers are necessary to describe the service provided.
These modifiers should be used in accordance with payer guidelines and specific clinical scenarios to ensure accurate billing and reimbursement. Always verify with the latest coding guidelines and payer policies, as these can change over time.
CPT code 90725, which pertains to the cholera vaccine injectable, is not reimbursed by Medicare. The Medicare Physician Fee Schedule (MPFS) does not include this specific CPT code, indicating that it is not covered under standard Medicare reimbursement policies.
Additionally, Medicare Administrative Contractors (MACs), which are responsible for processing claims and determining coverage specifics, typically follow the guidelines set forth by the MPFS. Therefore, healthcare providers should be aware that claims submitted for CPT code 90725 are unlikely to receive reimbursement from Medicare.
It is advisable for providers to verify coverage specifics with their respective MACs to ensure accurate billing practices.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 90725, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
