CPT code 90727 is a code used to identify the administration of the plague vaccine for healthcare providers.
CPT code 90727 is used to identify the administration of a plague vaccine via intramuscular injection. This code is part of the Current Procedural Terminology (CPT) system, which is utilized by healthcare providers to document and bill for medical procedures and services. The plague vaccine is typically administered to individuals who are at risk of exposure to Yersinia pestis, the bacterium that causes plague, often due to occupational or travel-related reasons. Proper use of this code ensures accurate billing and reimbursement for the vaccine administration.
For CPT code 90727, which pertains to the administration of the plague vaccine 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 necessary 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 needs to be 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 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 commonly applicable to vaccine administration, if the consultation regarding the vaccine is conducted via telemedicine, this modifier may be used.
6. Modifier 99: Multiple modifiers. This is used when two or more modifiers are necessary to describe the service provided.
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 90727, which pertains to a specific medical service, is not reimbursed by Medicare. The Medicare Physician Fee Schedule (MPFS) does not include this 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, do not list CPT 90727 as a reimbursable service.
Healthcare providers should verify with their local MAC for any updates or specific regional policies, but generally, this code is not eligible for Medicare reimbursement.
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