How To Use CPT Code 4035F

CPT 4035F describes the recommendation for influenza immunization in patients with chronic inflammatory bowel disease (IBD) to protect against complications from the highly contagious respiratory virus. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 4035F?

CPT 4035F can be used to document the provider’s recommendation for influenza vaccination in patients with chronic inflammatory bowel disease (IBD). This code indicates that the patient is at risk for life-threatening complications from influenza and should receive the vaccine to prevent such complications.

2. Official Description

The official description of CPT code 4035F is: ‘Influenza immunization recommended (COPD) (IBD).’ This code signifies that the provider has recommended influenza vaccination for a patient with chronic inflammatory bowel disease due to the risk of severe complications from the respiratory virus.

3. Procedure

1. The provider assesses the patient’s medical history and determines that the patient has chronic inflammatory bowel disease (IBD).
2. Based on the patient’s condition and treatment plan, the provider recommends influenza immunization to protect against complications from the highly contagious respiratory virus.
3. The provider documents the recommendation for influenza vaccination, along with the date of the encounter, in the patient’s healthcare record.

4. Qualifying circumstances

Patients eligible for CPT 4035F are those with chronic inflammatory bowel disease (IBD) who are at risk for severe complications from influenza. These patients may be undergoing treatment with medications that suppress the immune system, leaving them more vulnerable to respiratory infections like pneumonia and sepsis. The provider must document the recommendation for influenza immunization in the patient’s healthcare record.

5. When to use CPT code 4035F

CPT code 4035F should be used when the provider recommends influenza immunization for a patient with chronic inflammatory bowel disease (IBD). This code indicates that the patient is at risk for complications from influenza and should receive the vaccine to protect against these complications.

6. Documentation requirements

To support a claim for CPT 4035F, the provider must document the following information:

• Patient’s diagnosis of chronic inflammatory bowel disease (IBD)
• Provider’s recommendation for influenza immunization
• Date of the encounter when the recommendation was made

7. Billing guidelines

When reporting CPT 4035F, ensure that the provider has recommended influenza immunization for a patient with chronic inflammatory bowel disease (IBD). This code should be reported along with other relevant codes for the encounter, if applicable. It is important to follow the specific billing guidelines of the payer to ensure accurate reimbursement.

8. Historical information

CPT 4035F was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates or changes to the code since its addition.

9. Examples

1. A gastroenterologist recommends influenza immunization for a patient with Crohn’s disease to protect against complications from the respiratory virus.
2. A primary care physician advises influenza vaccination for a patient with ulcerative colitis to prevent severe respiratory infections.
3. An IBD specialist recommends influenza immunization for a patient with chronic inflammatory bowel disease due to the increased risk of complications from the highly contagious respiratory virus.
4. A gastroenterologist documents the recommendation for influenza vaccination in the healthcare record of a patient with IBD to ensure the patient receives appropriate preventive care.
5. A nurse practitioner advises influenza immunization for a patient with inflammatory bowel disease to protect against respiratory infections and related complications.
6. A gastroenterologist recommends influenza vaccination for a patient with Crohn’s disease to reduce the risk of severe respiratory illnesses.
7. An IBD specialist advises influenza immunization for a patient with chronic inflammatory bowel disease to prevent complications from the highly contagious respiratory virus.
8. A primary care physician documents the recommendation for influenza vaccination in the healthcare record of a patient with ulcerative colitis to ensure appropriate preventive care.
9. A nurse practitioner advises influenza immunization for a patient with inflammatory bowel disease to protect against respiratory infections and related complications.
10. A gastroenterologist recommends influenza vaccination for a patient with Crohn’s disease to reduce the risk of severe respiratory illnesses.