ICD-10-CM diagnosis code required for billing is Z23 - Encounter for immunization. Providers must bill with CPT code: 90750 - Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection. One Medicaid unit of coverage is 0.5 mL. The maximum reimbursement rate per unit is $144.20.
The CPT® code for Shingrix is 90750, and of course, there is only one ICD-10 code to remember for immunizations, Z23. The patient needs two doses, separated by at least 2 months.
Inoculations and Vaccinations ICD-10-CM Coding Code Z23, which is used to identify encounters for inoculations and vaccinations, indicates that a patient is being seen to receive a prophylactic inoculation against a disease.
ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
Immunization administration for90472: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, each additional vaccine. 90474: Immunization administration for intra-nasal or oral route, each additional vaccine.
Does Medicare cover Shingrix? Yes, all Medicare Part D plans cover this drug, and Medicare Advantage plans with built-in Part D coverage will also cover Shingrix. Also, you may not need a prescription if you are paying for this drug yourself. Ask your pharmacist if they require you to get one.
According to ICD-10-CM guidelines, clinicians may assign code Z28. 310, “Unvaccinated for COVID-19,” when the patient has not received a dose of any COVID-19 vaccine. Clinicians may assign code Z28.
If the immunization is related to exposure (eg, the administration of a Tdap vaccine as a part of wound care), the ICD-10 code describing the exposure should be used as the primary diagnosis code for the vaccine, and Z23 should be used as the secondary code.
Other specified counselingICD-10 code Z71. 89 for Other specified counseling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Vaccine Administration Code(s) Administration codes track which dose in the regimen is being administered. NDC 10/NDC11 The National Drug Code (NDC) uniquely identifies human drugs in the United States; it can be found on the vial containing the vaccine.
Administration services for these preventive vaccines are reported to Medicare using HCPCS codes as follows:G0008 administration of influenza virus vaccine.G0009 administration of pneumococcal vaccine.G0010 administration of Hepatitis B vaccine.
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.