CPT code 90744 is a code used to identify the administration of the hepatitis B vaccine in children and adolescents.
CPT code 90744 is used to identify the administration of the hepatitis B vaccine, specifically the three-dose series, for pediatric and adolescent patients. This code is applicable when the vaccine is given intramuscularly (IM), which is the standard method for administering this type of vaccine. The hepatitis B vaccine is crucial for protecting against the hepatitis B virus, which can cause serious liver infections. This code is typically used by healthcare providers to document and bill for the vaccination service provided to younger patients.
For CPT code 90744, which pertains to the administration of the Hepatitis B vaccine (3-dose schedule) for pediatric and adolescent patients via intramuscular injection, the following modifiers may 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. This modifier is used when 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 multiple vaccines are administered and need to be distinguished from one another.
3. Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional. This modifier is used if the vaccine is administered more than once on the same day due to a repeat procedure.
4. Modifier 77: Repeat Procedure by Another Physician or Other Qualified Health Care 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. Although not typically applicable to vaccine administration, if any part of the service involves telemedicine, this modifier may be used.
6. Modifier SL: State Supplied Vaccine. This modifier is used when the vaccine is provided to the provider at no cost by the state.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 90744 is associated with the administration of a hepatitis B vaccine in a three-dose schedule for pediatric and adolescent patients. Whether this code is reimbursed by Medicare depends on several factors, including the specific circumstances under which the vaccine is administered and the patient's eligibility.
Medicare typically covers vaccines under Part B or Part D, depending on the type of vaccine and the setting in which it is administered. For CPT code 90744, reimbursement through Medicare Part B may be possible if the vaccine is administered as part of a preventive service covered under the Medicare Physician Fee Schedule (MPFS). However, it is essential to verify coverage specifics with the Medicare Administrative Contractor (MAC) that processes claims in your region, as they provide guidance on local coverage determinations and reimbursement policies.
Healthcare providers should consult the MPFS and their respective MAC to confirm whether CPT code 90744 is reimbursed under Medicare and to understand any documentation or billing requirements that may apply.
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