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Prescribing Information

Coding for BOOSTRIX

Here you’ll find vaccine product codes and some common administration codes associated with immunization using BOOSTRIX. Select another vaccine here.

Vaccine administration codes are dependent on the services provided. Please refer to the latest edition of Current Procedural Terminology (CPT) for appropriate administration codes, and the latest edition of International Classification of Diseases (ICD) manual for appropriate diagnosis codes.

Description: BOOSTRIX is available in 0.5-mL single-dose vials and disposable prefilled Tip-Lok syringes (packaged without needles).1

Adolescent/adult dosage: 0.5 mL1

Coding for BOOSTRIX

CPT Code

90715

ICD-10-CM Code2,*

Z23

MVX Code3

SKB

CVX Code4

115

NDCs† (Vial in package of 10)

Vial

NDC 58160-842-01

Outer Carton

NDC 58160-842-11

NDCs† (Syringe in package of 10)

Syringe

NDC 58160-842-43

Outer Carton

NDC 58160-842-52
Tip

Tip

To promote accuracy, always consult the most current Prescribing Information or product packaging when documenting NDCs.

BOOSTRIX CPT Code – Immunization Administration Codes5,‡

90460:

Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered 

 

+90461:

Each additional vaccine or toxoid component administered (List separately in addition to code for primary procedure)

 

90471:

Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)

+90472:

Each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)

Tip

Tip

If reporting multiple vaccine administrations given to a patient through age 18 on the same date along with counseling by a qualified healthcare professional, report one administration code (90460) for each vaccine administered.

If a vaccine has multiple components, then 90460 should be reported once in conjunction with 90461 for each additional vaccine/toxoid component contained within that vaccine.6

Diagnosis Codes

Z23 is the ICD-10-CM code used when reporting an encounter for immunization for all vaccines given within the encounter. In some instances, additional ICD-10-CM coding may be needed. 

See all code types

GSK Codes Summary Sheet

Get a PDF of the most current CPT, CVX, MVX, and NDC codes for GSK vaccines.

Download

Questions?

Find answers to frequently asked questions, along with additional resources, to guide you to the information you need.

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  •   *ICD-10-CM code Z23, Encounter for Immunization, is reported for all vaccines given within an encounter; additional ICD-10-CM coding may be needed.2
  •   †Note that some payers require an 11-digit NDC, which involves adding a "0" immediately after the first hyphen in each GSK NDC.7 For example, when reporting NDC 58160-820-11 to TRICARE, it becomes NDC 58160-0820-11.
  •    ‡Adapted from the American Medical Association, CPT 2024 Professional Edition, Current Procedural Terminology (CPT), 2023.

References:

  1. Prescribing Information for BOOSTRIX.
  2. 2024 ICD-10-CM official guidelines for coding and reporting. Centers for Medicare and Medicaid Services. Updated April 1, 2024. Accessed May 30, 2024. https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines-updated-02/01/2024.pdf
  3. Immunization information systems (IIS): HL7 standard code set, MVX – manufacturers of vaccines. Centers for Disease Control and Prevention. Accessed May 30, 2024. https://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=mvx
  4. Immunization information systems (IIS): Current HL7 standard code set, CVX – vaccines administered. Centers for Disease Control and Prevention. Accessed May 30, 2024. https://www2a.cdc.gov/vaccines/IIS/IISStandards/downloads/cvx_list.pdf
  5. CPT category I new vaccine codes (including incorporation of ACIP abbreviations listing) long descriptors. American Medical Association. Updated May 23, 2024. Accessed May 30, 2024. https://www.ama-assn.org/system/files/vaccine-long-descriptors.pdf
  6. Bright futures coding for pediatric preventive care 2022. American Academy of Pediatrics. Accessed May 30, 2024. https://downloads.aap.org/AAP/PDF/Coding%20Preventive%20Care.pdf
  7. Office injectable guidelines, National Drug Code (NDC) pricing and filing tips. Humana Military. Accessed May 30, 2024. 
    https://www.humanamilitary.com/provider/claims/injectables#nucleustabs-ee21c6fea3-item-098209c56a-tab

 

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.

Indications

BOOSTRIX is indicated for:

  • active booster immunization against tetanus, diphtheria, and pertussis in individuals aged 10 years and older;
  • immunization during the third trimester of pregnancy to prevent pertussis in infants younger than 2 months of age.

Important Safety Information

  • Contraindications for BOOSTRIX are: a known history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine or after a previous dose of any tetanus toxoid-, diphtheria toxoid-, or pertussis antigen-containing vaccine; and encephalopathy within 7 days of administration of a previous dose of a pertussis antigen-containing vaccine
  • Appropriate medical treatment to manage allergic reactions must be immediately available in the event an acute allergic reaction occurs following administration of BOOSTRIX
  • The tip cap of the prefilled syringe may or may not be made with natural rubber latex. Natural rubber latex may cause allergic reactions. Please check the carton
  • The decision to give BOOSTRIX should be based on benefits and risks if Guillain-Barré syndrome occurred within 6 weeks of receipt of a prior tetanus toxoid-containing vaccine
  • Progressive or unstable neurologic conditions are reasons to defer vaccination with a pertussis-containing vaccine, including BOOSTRIX
  • Persons who experienced an Arthus-type hypersensitivity reaction following a prior dose of tetanus toxoid-containing vaccine should not receive BOOSTRIX unless 10 years have elapsed since the last dose of a tetanus toxoid-containing vaccine
  • If BOOSTRIX is administered to immunosuppressed persons, including individuals receiving immunosuppressive therapy, the expected immune response may not be obtained
  • Syncope (fainting) may occur in association with administration of injectable vaccines. Procedures should be in place to avoid injury from fainting
  • Common solicited adverse reactions (≥15%) in adolescents (aged 10 to 18 years) were pain, redness, and swelling at the injection site; increase in arm circumference of the injected arm; headache; fatigue; and gastrointestinal symptoms
  • Common solicited adverse reactions (≥15%) in adults (aged 19 to 64 years) were pain, redness, and swelling at the injection site; headache; fatigue; and gastrointestinal symptoms
  • The most common solicited adverse reaction (≥15%) in the elderly (aged 65 years and older) was pain at the injection site
  • Pregnancy: Available data from a controlled clinical study showed that the use of the non-U.S. formulation of BOOSTRIX* during the third trimester of pregnancy did not reveal any vaccine-related adverse effects on pregnancy or on the fetus/newborn child
  • Pregnancy Registry: HCPs are encouraged to register pregnant individuals by calling 1-888-452-9622 or visiting http://pregnancyregistry.gsk.com/boostrix.html
  • Vaccination with BOOSTRIX may not result in protection in all vaccine recipients

* The non-U.S. formulation of BOOSTRIX is manufactured to contain 0.5 mg aluminum per dose. The U.S. formulation is manufactured to contain 0.3 mg aluminum per dose.

Please see full Prescribing Information for BOOSTRIX.