ICD-9-CM®a Codes
This page provides a listing of some ICD-9-CMa codes commonly used that may apply to private payer reimbursement claims for vaccination with certain Merck vaccines.
ICD-9-CM codes may be utilized or mandated by payers to describe the viral disease for which the prophylactic vaccination is administered. Plan coding requirements may vary or change so it is important to check with each plan as to plan-specific requirements. For claim submission procedures regarding government programs (eg Medicaid) contact the appropriate program representative.
The information provided here is not intended to be conclusive or exhaustive. You are solely responsible for determining the appropriate codes and for any action you take in billing for a Merck vaccine. Diagnosis codes should be selected only by a health care professional. Consult the ICD-9-CM manual to check the appropriateness of a particular code and for information on additional codes. Merck makes no warranties or guarantees, expressed or implied concerning the accuracy or appropriateness of this information for any particular use. The use of this information does not guarantee payment or that any payment received will cover your costs.
The following table lists various generic and non-generic vaccination codes that may be associated with certain Merck vaccines and related services. When billing for a vaccine, you will also need to provide the appropriate CPTb code for that vaccine, as most payers reference the CPT® code when processing reimbursement claims. It is possible that you may also need to include additional diagnosis codes based on the patient's medical condition, as indicated by the physician; however, Merck cannot recommend the use of any specific diagnosis code.
We trust that you will find this information helpful. For questions regarding a specific plan's billing requirements, you should contact the plan directly. If you have questions regarding a denied or under-paid claim the Merck Vaccine Reimbursement Support Center (at 1-800-734-6282) may be able to provide assistance. For Medicaid specific billing requirements, you should contact your state Medicaid program directly. A listing of state Medicaid program contact information can be found at www.nasmd.org/members.htm.
This page reflects information available to Merck as of February, 2008.
| ICD‑9‑CM Code |
Vaccine Category |
Description |
| V04.89 |
HPV |
Need for prophylactic vaccination and inoculation against certain viral diseases; other viral disease |
| V05.8 |
HPV |
Need for prophylactic vaccination and inoculation against a single disease; other specified disease |
| V06.8 |
Measles, Mumps, Rubella, Varicella |
Need for prophylactic vaccination and inoculation against combinations of diseases, specified type |
| V06.9 |
Measles, Mumps, Rubella, Varicella |
Need for prophylactic vaccination and inoculation against combination of diseases |
| V05.4 & V06.4 |
Measles, Mumps, Rubella, Varicella |
Need for other prophylactic vaccination and inoculation against single disease, varicella; need for prophylactic vaccination and inoculation against combination of diseases, measles-mumps-rubella |
| V04.89 |
Rotavirus |
Need for prophylactic vaccination and inoculation against certain viral diseases; other viral disease |
| V05.8 |
Rotavirus |
Need for prophylactic vaccination and inoculation against a single disease; other specified disease |
| V04.89 |
Zoster |
Need for prophylactic vaccination and inoculation against certain viral diseases; other viral disease |
| V05.8 |
Zoster |
Need for prophylactic vaccination and inoculation against a single disease; other specified disease |
| V03.82 |
Streptococcus Pneumoniae |
Need for prophylactic vaccination against streptococcus pneumoniae (pneumococcus) |
Before administering any Merck vaccine, please read the appropriate Prescribing Information.
a Physician ICD-9-CM © 2008 American Medical Association. All Rights Reserved.
b Current Procedural Terminology © 2008 American Medical Association. All rights reserved.This information is current as of February, 2008. Confirm all coding and billing information with individual third-party payers, as policies may differ or change. The codes provided on this page serve only as a guide, and their use does not guarantee reimbursement. It is the responsibility of each provider to ensure that the billing and coding for all services and products are appropriate and correct.