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References
  1. Medicare & You 2016. Medicare.gov website managed by the Centers for Medicare & Medicaid Services. https://www.medicare.gov/Pubs/pdf/10050.pdf. Accessed July 13, 2016.
  2. Billing & Coding Adult Immunizations. American College of Physicians website. http://www.acponline.org/running_practice/payment_coding/coding/billvaccines.pdf. Accessed July 13, 2016.
  3. Medicaid moving forward. Kaiser Family Foundation website (KFF.org). Mar 09, 2015. http://kff.org/health-reform/issue-brief/medicaid-moving-forward/. Accessed July 13, 2016.
  4. How Health Insurance Works. HCSC (Health Care Service Corporation) website. http://www.hcsc.com/how_insurance_works.html. Accessed July 20, 2016.
  5. Coding at the AAP: Bright Future and Preventative Medicine Coding Fact Sheet. American Academy of Pediatrics website. https://www.aap.org/en-us/professional-resources/practice-support/Coding-at-the-AAP/Pages/Bright-Futures-and-Preventitive-Medicine-Coding-Fact-Sheet.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed July 20, 2016.
  6. American Medical Association. CPT 2017 Professional Edition. Chicago, IL: AMA Press; 2016.
  7. American Medical Association. HCPCS 2016 Level II Professional Edition. Salt Lake City, UT: AMA; 2015.
  8. Optum360. 2016 ICD-10-CM Expert for Physicians. Salt Lake City, Utah: Optum360; 2016.
  9. Modifier 25 Primer: Use It, Don't Abuse It. American Academy of Pediatrics website. https://www.aap.org/en-us/professional-resources/practice-support/Coding-at-the-AAP/Pages/Modifier-25-Primer-Use-It-Dont-Abuse-It.aspxnfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed July 20, 2016.
  10. Hamilton B. Electronic health records. 3rd ed. Philadelphia, PA: McGraw-Hill Higher Education; 2012.
  11. 1500 Health Insurance Claim Form Reference Instruction Manual for Form Version 02/12. National Uniform Claim Committee website. Updated July 2016. Version 4.0. http://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v4.pdf. Accessed July 20, 2016.
  12. Medicare Claims Processing Manual Chapter 26 - Completing and Processing Form CMS-1500 Data Set. Rev. 3547, June 2016. CMS.gov website managed by the Centers for Medicare and Medicaid Services. http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf. Accessed July 20, 2016.
  13. Coding for Pediatric Preventive Care. American Academy of Pediatrics website. https://www.aap.org/en-us/Documents/coding_factsheet_brightfuturespreventivemedicine.pdf. Accessed July 20, 2016.
  14. Office injectable guidelines National drug code (NDC) pricing and filing tips. Humana Military website. https://www.humanamilitary.com/provider/claims/office-injectables. Accessed July 20, 2016.
  15. Dyson K. Procedural coding changes for 2013: an overview. Med Bus J. 2012;7(3):6-15.
  16. Family practice management (FPM) superbill. American Academy of Family Physicians website. http://www.aafp.org/fpm/icd9/fpmsuperbill.pdf. Updated 2013. Accessed February 6, 2014.
  17. Coding at the AAP: FAQ. American Academy of Pediatrics website. https://www.aap.org/en-us/professional-resources/practice-support/Coding-at-the-AAP/Pages/FAQ.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed July 28, 2016.
  18. 2014 Recommended Immunizations for Children from Birth Through 6 Years Old. Centers for Disease Control and Prevention website. http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf. Updated 2013. Accessed February 6, 2014.
  19. Prescribing Information for ENGERIX-B.
  20. Prescribing Information for HAVRIX.
  21. Prescribing Information for HIBERIX.
  22. Prescribing Information for FLUARIX QUADRIVALENT.
  23. Prescribing Information for RABAVERT.
  24. Prescribing Information for FLULAVAL QUADRIVALENT.
  25. Prescribing Information for INFANRIX.
  26. Prescribing Information for KINRIX.
  27. Prescribing Information for PEDIARIX.
  28. Prescribing Information for BEXSERO.
  29. Prescribing Information for ROTARIX.
  30. 2014 Recommended Immunizations for Children from 7 Through 18 Years Old. Centers for Disease Control and Prevention website. http://www.cdc.gov/vaccines/who/teens/downloads/parent-version-schedule-7-18yrs.pdf. Updated 2014. Accessed February 6, 2014.
  31. Prescribing Information for BOOSTRIX.
  32. Prescribing Information for MENVEO.
  33. Prescribing Information for TWINRIX.
  34. VFC Detailed Questions and Answers for Parents. Centers for Disease Control and Prevention website. http://www.cdc.gov/vaccines/programs/vfc/parents/qa-detailed.html. Accessed July 20, 2016.
  35. About VFC. Centers for Disease Control and Prevention website. http://www.cdc.gov/vaccines/programs/vfc/about/index.html. Accessed July 20, 2016.
  36. Harvard Pilgrim HealthCare--Provider Manual. Payment Policies: Vaccine and Immunization. Harvard Pilgrim HealthCare website. https://www.harvardpilgrim.org/pls/portal/docs/page/providers/manuals/payment%20policies/h-6%20vaccine_041516.pdf. Accessed July 20, 2016.
  37. Vaccines For Children Policy. UnitedHealthcare website. https://www.uhccommunityplan.com/content/dam/
    communityplan/healthcareprofessionals/reimbursementpolicies/Vaccines-For-Children-Policy-(R7109).pdf. Accessed July 20, 2016.
  38. ACA increases reimbursement for primary care services in 2013 and 2014. IHCP bulletin. November 2012. Indiana Medicaid.com website. http://provider.indianamedicaid.com/ihcp/bulletins/BT201247.pdf. Accessed July 20, 2016.
  39. Directory of Immunization Resources. Immunization Action Coalition website. http://www.immunize.org/resources/. Accessed July 20, 2016.
  40. Affordable Care Act: Working with States to Protect Consumers. CMS.gov website managed by the Centers for Medicare & Medicaid Services. http://www.cms.gov/CCIIO/Resources/Files/working_with_states_to_protect_consumers_06222011.html. Accessed July 20, 2016.
  41. Glossary. CMS.gov website managed by the Centers for Medicare & Medicaid Services. https://www.cms.gov/apps/glossary/. Updated 2006. Accessed February 6, 2014.
  42. Helping People Understand Their Explanation of Benefits (EOB). Medicare.gov website managed by the Centers for Medicare & Medicaid Services. http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/downloads/11234-P.pdf. Accessed February 7, 2014.
  43. Patient Financial Responsibility. American Academy of Orthopaedic Surgeons (AAOS) website. http://orthodoc.aaos.org/JeffreyAndersonMD/Patient%20Financial%20Responsibility%20Agreement.pdf. Updated 2013. Accessed February 6, 2014.
  44. Kaiser Permanente Provider Manual. 2009. http://providers.kaiserpermanente.org/info_assets/cpp_knw/nw_section5-manual_0610.pdf. Updated 2011. Accessed February 6, 2014.
  45. Remittance Advice Information: An Overview. Centers for Medicare & Medicaid Services website. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Remit-Advice-Overview-Fact-Sheet-ICN908325.pdf. Accessed February 7, 2014.
  46. Prescribing Information for SHINGRIX.

826034R0 October 2017

Please note that this website is provided for informational purposes only and is not intended to serve as comprehensive training on medical billing and coding. Additional training on medical coding may be required. The information on this website is believed to be accurate as of the date of publication. Users should independently verify accuracy.

Healthcare providers are responsible for making the ultimate decision on when to use a specific product based on clinical recommendations and how to bill for products and related services rendered. Consult third-party insurers' guidelines for specific information regarding the billing and reporting of services rendered.

You are encouraged to report vaccine adverse events to the US Department of Health and Human Services.
Visit www.vaers.hhs.gov to file a report, or call 1-800-822-7967.

To learn more about the
GSK Vaccines Access Program,
click here.
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