Medical Coding Certification- the medicine
section- vaccines. RS asks, “A one year old receives 2 vaccines after the parent was
counseled, DT and IM injectable poliomyelitis. How to code vaccines and administration? Does
the order of the vaccines matter?” And maybe, Alicia, I got to get my document camera going.
Maybe you could read the answer for that while I find this. Alicia: Okay. I like how Laureen puts this.
This is a stick and stuff scenario so we need a code to describe the administration or stick
and one or more code is the vaccines or stuff. And no, the order of the vaccine does not
matter. So she’s going to pull up the CPT so you can actually see this. Laureen: Yeah, I’m going to go 458. Okay,
good. Whew, it worked! I forgot to test it. That’s why I was panicking a little bit. Okay so this is where the guideline start
and for me, when I was first learning how to code, I need to do funny little word games.
So stick and stuff made me remember, “Oh, administration and the product”, the vaccine
or the immunoglobulin, if you’re talking about that. So you have to make sure you’re using the
right stick code with the right stuff code. So here, it’s telling us to report a vaccine
immunization administration codes with this range which is coming next, in addition to the vaccine i.e. product codes.
And this is one of the rare instances in CPT where they actually do have codes for a product
or a thing or an item. Most of those we find in HCPCS, okay. So let’s take a look at 459 and what I’ve
started to do with my bubbling and highlighting… oh which by the way, I forgot to tell Boyd
to make the announcement. Bubbling and highlighting is an official trademarked term by codingcertification.org
so yay! I’m trademarked. Boyd: Really? Congratulations! Laureen: Thanks. So this bubble here, 90460,
I’ve labeled it vaccine toxoid stick. Okay and I did the same thing for 471 and 472.
So now what we need to do is figure out, well, what’s with the difference between these
2 groups? So this one is though 18 years of age via
any route of administration with counsel. So this is where that counseling comes in.
And this is the first or only component of each vaccine or toxoid administered and then
the 461 is each additional. Okay now the next grouping is talking about
percutaneous, intradermal, subcu or intramuscular injections, one vaccine. Now you’ll notice
here, it doesn’t talk about counseling. Okay so if we wanted to, we can even just
say with counseling and then here, no counsel. And that’s really what you want to do throughout
your book, find the differences. So that when you go to take a board exam or in real world
coding, you can quickly compare and contrast and pick out the best one. And then the third bubble is oral or nasal.
Okay so intranasal or oral. So for our question, let’s see what she said. So here, she has
injectable, okay. And it did talk about counseling and it’s a one year old. Okay so we can
see that we’re going to be in this bubble here, the 460 bubble. Okay? And then what comes next after the stick codes
is the stuff codes and you can see the guidelines are talking about vaccines, toxoids and stuff.
Okay so we’ve got this code so then what I like to do with these is I kind of bracket
when they have the same name so 90476 and 90477. Is that a true bubble when you learn how to
do bubbling and highlighting? Because we only bubble in indented codes so this is… I should
have called it bubbling, highlighting and bracketing. But these are both the adeno virus
and then you’d want to look at the differences. This is a type 4, this is type 7 and you know,
oral use etcetera. So what you would do… what did she say she
had? Poliomyelitis. Let’s see if I can find that real quick here. If anyone finds it,
type it in. Polio… polio… I found some of the… Alicia: The polio code Laureen: Pardon? Alicia: I used to have it memorized and I
don’t remember… Laureen: Oh here it is, 90712 and 3. Okay
and so you see live for oral use and subcu. So we know that the route of administration
was an injection so it’s got to be the 90713. Okay? So that’s how you do it. You do the
same thing for the DT, the diptheria and tetanus, I think it is. Okay so stick and stuff. Hopefully
that will help you remember that one.