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Coding for ROTARIX

Here you’ll find vaccine product codes and some common administration codes associated with immunization using ROTARIX. 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.

ROTARIX is supplied as either:

  • Vial and oral dosing applicator presentation: The vial contains the lyophilized vaccine component and the oral dosing applicator contains the diluent. The contents of teh vial must be reconstituted with the diluent to form ROTARIX prior to adminstration.1
  • Oral dosing applicator only presentation: The oral dosing applicator contains ROTARIX and does NOT require reconstitution or dilution before use.1

The tip caps of the prefilled oral dosing applicators contain natural rubber latex which may cause allergic reactions.1


  • Vial and oral dosing applicator presentation: a single dose is 1 mL1
  • Oral dosing applicator only presentation: a single dose is 1.5 mL1

Coding for ROTARIX

CPT Code


ICD-10-CM Code2*


MVX Code3


CVX Code4


NDCs† (vial and oral dosing applicator presentation)

Outer Carton


NDC 58160-854-52


  • Package of 10 Vials

NDC 58160-851-10

Vial of Lyophilized Vaccine


NDC 58160-851-01


  • Oral Applicator of Diluent (10 applicators)

NDC 58160-853-02

NDCs† (oral dosing applicator only presentation)

Outer Carton


NDC 58160-740-21


  • 1 prefilled oral dosing applicator with a plunger stopper

NDC 58160-740-02



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

ROTARIX CPT Code – Immunization Administration Codes5



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.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.



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 2023 Professional Edition, Current Procedural Terminology (CPT), 2023.


  1. Prescribing Information for ROTARIX.
  2. Centers for Medicare and Medicaid Services. 2021 ICD-10-CM official guidelines for coding and reporting. Updated January 1, 2021. Accessed January 5, 2023.
  3. Centers for Disease Control and Prevention. Immunization information systems (IIS): HL7 standard code set, MVX – manufacturers of vaccines. Accessed January 5, 2023.
  4. Centers for Disease Control and Prevention. Immunization information systems (IIS): Current HL7 standard code set, CVX – vaccines administered. Accessed January 5, 2023.
  5. American Medical Association. CPT category I new vaccine codes (including incorporation of ACIP abbreviations listing) long descriptors. Updated December 29, 2022. Accessed January 5, 2023.
  6. American Academy of Pediatrics. Bright futures coding for pediatric preventive care 2022. Accessed January 5, 2023.
  7. Humana Military. Office injectable guidelines, national drug code (NDC) pricing and filing tips. Accessed January 5, 2023.

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.