About this policy
Tetanus is a neurologic syndrome caused by a neurotoxin elaborated at the site of injury by Clostridium tetani. Nearly all cases of tetanus occur in nonimmunized or inadequately immunized individuals. In the absence of an injury or direct exposure to tetanus, preventative immunization is not covered. Coding Guidance If the provider knows the service is non-covered or is not a Medicare benefit, the GY modifier must be appended to the CPT/HCPCS code indicating the item or service is statutorily non-covered or does not meet the definition of any Medicare benefit. Documentation Requirements All documentation must be maintained in the patient’s medical record and made available to the contractor upon request. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Showing the first 1,000 of 3,646 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 90714 | HCPCS | Covered |
| 90715 | HCPCS | Covered |
| S00.01XA | ICD10CM | Covered |
| S00.01XD | ICD10CM | Covered |
| S00.05XA | ICD10CM | Covered |
| S00.05XD | ICD10CM | Covered |
| S00.07XA | ICD10CM | Covered |
| S00.07XD | ICD10CM | Covered |
| S00.211A | ICD10CM | Covered |
| S00.211D | ICD10CM | Covered |
| S00.212A | ICD10CM | Covered |