Telephone Receiver Handset

Any Questions?

Contact the Vaccines
Reimbursement
Support Center

Learn More

Diagnosis Codes

This section provides some common diagnosis codes associated with immunization using pediatric, adolescent, and adult patients with GSK products. The diagnosis codes may vary based on the nature of the medical visit and the patient's health status.

The ICD-9-CM code set used to report medical diagnoses will be replaced by ICD-10-CM code set on October 1, 2015. The change to ICD-10 will affect everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims. Claims for services provided on or after the compliance date should be submitted with ICD-10 diagnosis codes. The change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.

Please refer to your most up-to-date Current Procedural Terminology (CPT*) and International Classification of Diseases (ICD) manuals for appropriate coding. Examples of coding for vaccines in various situations follow.

Common ICD-10-CM Codes Associated With Pediatric Immunization [8]
ICD-10-CM Description
Z23 Encounter for immunization
Z20.3 Contact with and (suspected) exposure to rabies
A82.0 Sylvatic rabies
A82.1 Urban rabies
A82.9 Rabies, unspecified

This is not a complete list of diagnosis codes; please refer to the 2015 ICD-10-CM coding manual for specific guidance.

Some of these codes may only cover general disease states, and not the complications or other medical conditions that might be caused by the disease. To help ensure proper documentation, please consult the official 2015 ICD-10-CM coding manual for additional coding if needed, and select the most appropriate codes for each individual patient.

*CPT codes are part of the Current Procedural Terminology (CPT) system published and maintained by the American Medical Association (AMA).
ICD-10 codes are part of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) official coding system used for diagnoses.

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.
Contact Us