CPT code 90733 is a code used to identify the MPSV4 vaccine administered subcutaneously in healthcare documentation and reporting.
CPT code 90733 is used to identify the administration of the meningococcal polysaccharide vaccine, also known as MPSV4, which is given via subcutaneous injection. This vaccine is designed to protect against meningococcal disease, a serious bacterial illness that can lead to infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia). The code is utilized by healthcare providers to document and bill for the administration of this specific vaccine in a clinical setting.
For CPT code 90733, which pertains to the administration of the Meningococcal Polysaccharide Vaccine, there are no specific modifiers that are universally required. However, depending on the circumstances of the service provided, the following modifiers might be applicable:
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 provider on the same day as the vaccine administration.
2. Modifier 59: Distinct Procedural Service. This modifier may be used if the vaccine administration is distinct or independent from other services provided on the same day.
3. Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional. Use this modifier if the vaccine is administered more than once on the same day due to clinical necessity.
4. Modifier 77: Repeat Procedure by Another Physician or Other Qualified Health Care Professional. This modifier is applicable if the vaccine is administered more than once on the same day by a different provider.
5. Modifier 91: Repeat Clinical Diagnostic Laboratory Test. Although not typically used for vaccines, if the administration of the vaccine is part of a diagnostic procedure that needs repeating, this modifier might be applicable.
6. Modifier 99: Multiple Modifiers. Use this when more than four modifiers are necessary to describe the service provided.
It is important to verify payer-specific guidelines, as some payers may have unique requirements for the use of modifiers with vaccine administration codes.
CPT code 90733, which is associated with the Mpsv4 vaccine administered subcutaneously, is not typically reimbursed by Medicare under the Medicare Physician Fee Schedule (MPFS). Medicare coverage for vaccines is generally limited to those that are explicitly covered under Medicare Part B, such as influenza, pneumococcal, and hepatitis B vaccines, or those covered under Medicare Part D plans.
For specific coverage details, healthcare providers should consult their local Medicare Administrative Contractor (MAC), as MACs are responsible for interpreting national policies and making local coverage determinations. It's important to verify with the MAC to understand any regional variations or specific billing requirements that might affect reimbursement for this particular CPT code.
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