Stick and Stuff Medical Codes – Video

Q: Next question, stick & stuff medical codes. Now, this I know is a student because this is exactly how I teach it. I love it how they talk to me. The question is: For code 90636 “stuff” HepA & HepB would I use “stick” code 90471. Code 90645 (4 dose schedule) is each dose scheduled at different times; if so, would you use “stuff code” 90645 and “stick” code 90471?

Stick and Stuff Medical Codes – Video

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A: What I do when I first started learning coding, I would get confused when you would say an “injection” like are you talking about coding for what you’re injecting, or are you talking about the service of sticking it to the patient, so that’s where I came up with “stick and stuff.” It helps me to understand that there’s two pieces to this picture.

The “stick” is the administration code and the “stuff” is the product. So, what this student is asking – if you look at the screenshot from SuperCoder here, 90471 is an administration code which is a “stick” code. Whereas, the other two codes she asked about the HepA & HepB and the Hemophilus. These are product codes or stuff codes. So, my answer is yes, you have it correct. The 90636 and 90645, the “stuff” codes both say intramuscular so they correspond to the “stick” code that says it’s for intramuscular, 90471. It’s also for the same product, the vaccines or toxoids, and this is immunization administration for vaccines and toxoids. You want to make sure your “stick” codes match your “stuff” codes. In that, you are absolutely correct.

Regarding your question about the 4-dose schedule, you would code them as a pair each time you give them that. So, the 4 doses just a heads-up that this product is designed to be given on a schedule of 4 times. I grabbed this from SuperCoder, it basically says: “The 4-dose schedule is recommended for infants at ages 2 months, 4 months, 6 months, with a booster does for those aged 12-15 months.” So, that kind of gives you an idea of how it’s normally spaced out. But each time they came in for it at 2 months, they would get a 90645 and a 90471. And they came back at 4 months, the same thing. At 6 months, the same thing. So, it’s not like you just use the 90645 once for all four times. You re-report it each time they come in for it. Sometimes, we know it happens, even though it’s a 4-dose schedule, they may only get it 3 of the 4 times, so you code it each time you do it. So, that’s a little preview of “stick and stuff.”

More Information about Medical Codes

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AAPC – Medical Coding 

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