CPT code 90740 is a code used to identify the administration of the Hepatitis B vaccine in three doses for immunosuppressed patients.
CPT code 90740 is used to describe the administration of the hepatitis B vaccine in a three-dose schedule specifically for patients who are immunosuppressed. This code is utilized by healthcare providers to document and bill for the vaccination process, ensuring that the patient receives the necessary protection against hepatitis B, which is particularly important for individuals with weakened immune systems. The code helps in tracking the specific type of vaccine and the patient population it is intended for, facilitating accurate billing and reimbursement processes.
For CPT code 90740, which pertains to the administration of the Hepatitis B vaccine in a three-dose schedule for immunosuppressed patients, 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 if 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 procedure 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 same procedure is repeated on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. Although not typically used for vaccine administration, this modifier may be relevant if the vaccine administration is part of a series of tests or procedures that are repeated for clinical reasons.
6. Modifier 95: Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. This modifier is used if the vaccine administration is part of a telemedicine service, although this is less common for vaccine administration.
These modifiers help clarify the context of the service provided and ensure accurate billing and reimbursement. It is important to review payer-specific guidelines as they may have specific requirements for the use of modifiers.
CPT code 90740 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, including their respective reimbursement rates. However, the actual reimbursement for CPT code 90740 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether and how much Medicare reimburses for this particular code. Therefore, healthcare providers should consult their specific MAC for detailed information on reimbursement rates and any additional requirements for CPT code 90740.
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