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Melissa Posted Tue 04th of June, 2013 12:54:37 PM

do you bill 90740 out three times per the dos or is the 90740 to be billed once to cover all three?

SuperCoder Answered Tue 04th of June, 2013 19:49:36 PM

Code 90740 represents a vaccine usually administered as a three–dose schedule. The second dose should be given one month after the first dose; the third dose should be given at least 2 months after the second dose and at least 4 months after the first dose. If the patient will be traveling to an area with higher hepatitis B incidence, vaccination ideally should begin at least 6 months before travel so the full vaccine series can be completed before the patient's departure.

Report 90740 once to cover all three.

Melissa Posted Wed 05th of June, 2013 12:55:04 PM

what about the admin code is the units going to be three? or do you bill each admin as the pt comes in?

Melissa Posted Fri 07th of June, 2013 11:00:32 AM

hi are there any responses to the admin code question? thank you

SuperCoder Answered Tue 11th of June, 2013 15:41:18 PM

Payers may create their own rules, but I found this in the April 2001 CPT Assistant: "There has also been some confusion that codes 90747 and 90740 are reported one time to represent the total three/four dose regimen. Codes 90740 and 90747 are reported each dose administered according to the 3 and 4 dose regimen. If a complete series was administered, 90740 would be billed 3 times and 90747 would be billed 4 times."

It could be written more clearly, but a logical interpretation is that you bill the admin code and the vaccine code separately for each encounter. Further examples in the article support this by discussing using "1" in the units box for the admin code for a single encounter.

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