ICD-9 Codes that Support Medical Necessity
Tetanus Toxoid (CPT 90703)
870.0 - 897.7 - LACERATION OF SKIN OF EYELID AND PERIOCULAR AREA - TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) COMPLICATED
910.0 - 919.9 - ABRASION OR FRICTION BURN OF FACE NECK AND SCALP EXCEPT EYE WITHOUT INFECTION - OTHER AND UNSPECIFIED SUPERFICIAL INJURY OF OTHER MULTIPLE AND UNSPECIFIED SITES INFECTED
V03.7 - NEED FOR PROPHYLACTIC VACCINATION WITH TETANUS TOXOID ALONE
Tetanus and Diptheria toxoids (90702, 90714, 90718)
870.0 - 897.7 - LACERATION OF SKIN OF EYELID AND PERIOCULAR AREA - TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) COMPLICATED
910.0 - 919.9 - ABRASION OR FRICTION BURN OF FACE NECK AND SCALP EXCEPT EYE WITHOUT INFECTION - OTHER AND UNSPECIFIED SUPERFICIAL INJURY OF OTHER MULTIPLE AND UNSPECIFIED SITES INFECTED
V03.7 - NEED FOR PROPHYLACTIC VACCINATION WITH TETANUS TOXOID ALONE
Diptheria, Antitoxin (CPT 90296)
032.0 - 032.3 FAUCIAL DIPHTHERIA - LARYNGEAL DIPHTHERIA
032.81 - 032.85 CONJUNCTIVAL DIPHTHERIA - CUTANEOUS DIPHTHERIA
032.89 OTHER SPECIFIED DIPHTHERIA
032.9 DIPHTHERIA UNSPECIFIED
Rabies Prophylaxis (CPT 90675, 90676)
V01.5 CONTACT WITH OR EXPOSURE TO RABIES
Hepatitis A vaccine (CPT 90632, 90633, 90634)
V01.79 CONTACT OR EXPOSURE TO OTHER VIRAL DISEASES
Wednesday, August 11, 2010
Medicare physician fee schedule - Quick overview
Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download

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