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Coding for PRIORIX
Here you’ll find vaccine product codes and some common administration codes associated with immunization using PRIORIX. 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.
NDCs† (Supplied as 2 components in 1 box) |
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Outer Carton
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NDC 58160-824-15
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NDC 58160-831-03 |
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NDC 58160-833-02 |
Tip
To promote accuracy, always consult the most current Prescribing Information or product packaging when documenting NDCs.
PRIORIX CPT Immunization Administration Codes5‡
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
- * 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 2021 Professional Edition, Current Procedural Terminology (CPT), 2020.
References:
- Prescribing Information for PRIORIX.
- Centers for Medicare and Medicaid Services. 2021 ICD-10-CM official guidelines for coding and reporting. https://www.cms.gov/files/document/2021-coding-guidelines-updated-12162020.pdf. Accessed March 14, 2022.
- Centers for Disease Control and Prevention. Immunization information systems (IIS): HL7 standard code set, MVX – manufacturers of vaccines. https://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=mvx. Accessed March 14, 2022.
- Centers for Disease Control and Prevention. Immunization information systems (IIS): Current HL7 standard code set, CVX – vaccines administered. https://www2a.cdc.gov/vaccines/IIS/IISStandards/downloads/cvx_list.pdf. Accessed March 14, 2022.
- American Medical Association. CPT category I new vaccine codes (including incorporation of ACIP abbreviations listing) long descriptors. https://www.ama-assn.org/system/files/vaccine-long-descriptors.pdf. Accessed March 14, 2022.
- American Academy of Pediatrics. Bright futures coding for pediatric preventive care 2020. https://www.aap.org/en-us/documents/coding_preventive_care.pdf. Accessed March 14, 2022.
- Humana Military. Office injectable guidelines, national drug code (NDC) pricing and filing tips. https://www.humanamilitary.com/provider/education-and-resources/claims/office-injectable. Accessed March 14, 2022.
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.
