Coding and Reimbursement

Use the following codes when billing AREXVY:

CPT Code: product 90679
CPT Code: 1 vaccine administered 90471
CPT Code: Additional vaccine administered during same encounter 90472
ICD-10-CM Code Z23
MVX Code SKB
CVX Code 303
NDC: 10-dose carton 58160-848-11

For payers who require NDCs in an 11-digit format, please use: 58160-0848-11

CPT=Current Procedural Terminology; CVX=vaccine administered; ICD-10-CM=International Classification of Diseases, 10th Revision, Clinical Modification; MVX=Manufacturers of Vaccines; NDC=National Drug Code.

Billing and Coding Guide

A quick reference when coding for AREXVY

BILLING & CODING GUIDE
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GSK Vaccines Reimbursement Support Center

Visit the center for additional questions about billing, coding, and reimbursement for GSK vaccines.

 

Phone: 1-855-636-8291
Fax: 1-877-683-1329

Monday – Friday 8:00 am – 8:00 pm ET

REIMBURSEMENT SUPPORT CENTER
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GSK Vaccines Coverage Benefit Verification Site

This site provides support for understanding your patients’ insurance coverage. Healthcare professionals, offices, pharmacies, and systems can use this site to check their individual patient’s medical and pharmacy insurance benefit coverage for AREXVY. In most cases, enrolled users can expect a response to an individual benefit investigation within a minute.

COVERAGE BENEFIT VERIFICATION SITE

Indication & Important Safety Info

Indication

Important Safety Information

Indication

AREXVY is a vaccine indicated for active immunization for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in:

  • individuals 60 years of age and older;
  • individuals 50 through 59 years of age who are at increased risk for LRTD caused by RSV.

Important Safety Information

  • AREXVY is contraindicated in anyone with a history of a severe allergic reaction (eg, anaphylaxis) to any component of AREXVY
  • The results of a postmarketing observational study suggest an increased risk of Guillain-Barré syndrome during the 42 days following vaccination with AREXVY
  • Appropriate medical treatment must be immediately available to manage potential anaphylactic reactions following administration of AREXVY
  • Syncope (fainting) may occur in association with administration of injectable vaccines, including AREXVY. Procedures should be in place to avoid injury from fainting
  • Immunocompromised persons, including those receiving immunosuppressive therapy, may have a diminished immune response to AREXVY
  • In adults 60 years of age and older, the most commonly reported adverse reactions (≥10%) were injection site pain (60.9%), fatigue (33.6%), myalgia (28.9%), headache (27.2%), and arthralgia (18.1%)
  • In adults 50 through 59 years of age, the most commonly reported adverse reactions (≥10%) were injection site pain (75.8%), fatigue (39.8%), myalgia (35.6%), headache (31.7%), arthralgia (23.4%), erythema (13.2%), and swelling (10.4%)
  • There are no data on the use of AREXVY in pregnant or breastfeeding individuals. AREXVY is not approved for use in persons <50 years of age
  • Vaccination with AREXVY may not result in protection of all vaccine recipients

 

Please see full Prescribing Information.

To report SUSPECTED ADVERSE REACTIONS, contact GSK at gsk.public.reportum.com or
1-888-825-5249, or VAERS at 1-800-822-7967 or www.vaers.hhs.gov.

Questions About AREXVY?

Call: 1-877-AREXVY1 (1-877-273-9891) Available Monday - Friday 8:30 am - 5:30 pm ET