Medical Coding – Vaccine Administration – Video

Laureen: Next stop vaccine administration.

Q: I know one if by the MD and he is to doing face-to-face and give the shots, not the RN, is that correct? If it is given and a face-to-face with PA or a NP etc, that is coded another way. Can you over the scenarios? This has been a point of contention and how to interpret this guideline at our office. Much appreciated.

Half of the times we struggle with reading the questions, because I think people are typing how they talk.

Medical Coding – Vaccine Administration – Video

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A: This is my answer sheet for this one. What I did is I actually went in to the manual and copied my pages on these administration codes, and if you listened to my Blitz Video or my medical coding courses, you’ve heard me talk about sticking stuff. And when you think of it that way, whenever there is an injection or needlework, if you will, there’s two parts to it. It’s what is being injected into the patient and the act of injecting it, of sticking it to ‘em. So, these administration codes are the stick codes of that part of the puzzle.

So, they’re basically asking what’s the key differences between here, and she did recognize that one has physician involvement.

And this is this first bubble, the 90460 and 461 because it says here “with counseling by physician or other qualified health care professional.” In the 90471 bubble, it does not say anything about counseling. So, that’s the big difference; if there’s no counseling involved, then you use the 471 bubble. If there is counseling involved, you use the 460 bubble through 18 years of age. So these are for basically kids that are younger than 18, you do the 460 bubble. And these are vaccine or toxoid sticks; whereas, the 90473 bubble is intranasal or oral route, so that’s what makes this grouping different from the other two. Sometimes, I feel like it’s Sesame Street: which one doesn’t belong? This is part of our teaching technique for CPT, and by bubbling and grouping these codes and figuring out what the differences are and jotting them down in the margin, it makes things jump out at you for the board exam and also for real-world coding, you can kind of sort things out.

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