ICD-10-CM codes are used to report diseases and conditions. These will be needed on the CMS-1500 form.
View More InformationThis PDF provides a summary of CPT codes for GSK Vaccines.
View Summary SheetThis section provides the vaccine product codes as well as some common administration codes associated with immunization using SHINGRIX. Administration codes will vary based on the service provided. Please refer to your most up-to-date Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) manuals for appropriate coding.
SHINGRIX is a vaccine indicated for prevention of herpes zoster (shingles) in adults aged 50 years and older.
SHINGRIX is not indicated for prevention of primary varicella infection (chickenpox).
CPT Code |
Description [46] | NDCs* | ICD-10-CM Code [8]** |
|
---|---|---|---|---|
Adult dose: 0.5 mL |
90750 | SHINGRIX is supplied as 2 components: a single-dose vial of lyophilized gE antigen component (brown caps) and a single-dose vial of adjuvant suspension component (blue-green caps). | Z23 | |
SHINGRIX is supplied as an outer package of 1 dose | ||||
Lyophilized Antigen Vial: Adjuvant Suspension Vial: Outer Package: |
NDC 58160-828-01 NDC 58160-829-01 NDC 58160-819-12 | |||
SHINGRIX is supplied as an outer package of 10 doses | ||||
Lyophilized Antigen Vial: Adjuvant Suspension Vial: Outer Package: |
NDC 58160-828-03 NDC 58160-829-03 NDC 58160-823-11 |
* | Note that some payers require an 11-digit NDC, which involves adding a "0" immediately after the first hyphen in each GSK NDC. For example, when reporting NDC 58160-820-11 to TRICARE, it becomes NDC 58160-0820-11. [14] |
** | With the implementation of ICD-10-CM, all vaccine-related encounters are reported as code Z23 for all vaccines given. |
Immunization Administration Codes (CPT) [6] | |
---|---|
CPT | Immunization administration through 18 years of age with counseling by physician or other qualified healthcare professional |
90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), one vaccine (single or combination vaccine/toxoid) |
+90472 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) |
Adapted from American Medical Association. CPT 2016 Professional Edition. |
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826733R0 October 2017
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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.