Author Question: What are immunizations and how are they coded? What will be an ideal ... (Read 17 times)

tfester

  • Hero Member
  • *****
  • Posts: 534
What are immunizations and how are they coded?
 
  What will be an ideal response?

Question 2

Discuss the requirements for an SSO (second surgical opinion).
 
  What will be an ideal response?



pangili4

  • Sr. Member
  • ****
  • Posts: 346
Answer to Question 1

Answer:
Immunizations are the administration of a vaccine or toxoid (a weakened form of the toxin) to stimulate the immune system to provide protection against a certain disease or condition. The actual immunization administration (codes 9636596368, 96372, 96374, 96375 as appropriate) is coded in addition to the immune globulins (9028190399), and/or vaccine or toxin (9047690749) which has been injected.
When an immunization is the only service provided, the evaluation and management code for a minimal service exam is also allowed. If the vaccine is provided by the government, the provider cannot bill for the product.
Even though these services may take several visits or take a prolonged period of time, these codes are not to be used with the codes for prolonged services. The prolonged amount of time has been included in the RVS amount for these codes.

Answer to Question 2

Answer:
A second opinion or confirmatory consultation is designed as a benefit to the patient by confirming the need for surgeries that have a reputation for being done needlessly. Normally, for an SSO benefit to be payable, the following requirements must be satisfied:
a. The second or third opinion physician must be totally uninvolved with the original recommending physician. Therefore, he or she cannot be part of the same medical group and will often be picked by the administrator, medical management firm, or payer.
b. The consultation must be completed before the scheduling of surgery.
c. The second opinion physician cannot perform the recommended surgery.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
 

Did you know?

For about 100 years, scientists thought that peptic ulcers were caused by stress, spicy food, and alcohol. Later, researchers added stomach acid to the list of causes and began treating ulcers with antacids. Now it is known that peptic ulcers are predominantly caused by Helicobacter pylori, a spiral-shaped bacterium that normally exist in the stomach.

Did you know?

Computer programs are available that crosscheck a new drug's possible trade name with all other trade names currently available. These programs detect dangerous similarities between names and alert the manufacturer of the drug.

Did you know?

Allergies play a major part in the health of children. The most prevalent childhood allergies are milk, egg, soy, wheat, peanuts, tree nuts, and seafood.

Did you know?

In most climates, 8 to 10 glasses of water per day is recommended for adults. The best indicator for adequate fluid intake is frequent, clear urination.

Did you know?

Signs of depression include feeling sad most of the time for 2 weeks or longer; loss of interest in things normally enjoyed; lack of energy; sleep and appetite disturbances; weight changes; feelings of hopelessness, helplessness, or worthlessness; an inability to make decisions; and thoughts of death and suicide.

For a complete list of videos, visit our video library