a	Coverage is dependent on the terms and conditions of each patient's insurance benefit. Reimbursement may not always result in your costs being covered for individual patients due to various factors, including your contract with the health plan and the plan's reimbursement rate.
b	Current Procedural Terminology © 2008 American Medical Association. All Rights Reserved.

This information is intended to help your office:

• Access commonly used codes that may apply to private payer
  reimbursement claims

The CPT and ICD-9-CM^c codes below are commonly used codes that may apply to private payer reimbursement claims for vaccinations with RotaTeq.

Remember! Plan coding requirements vary

Plan coding requirements may vary and are subject to change at any time, so it is important to check with each plan as to plan-specific requirements. For claim submission procedures regarding government programs (eg, Vaccines for Children), contact the appropriate program representative.

The above information 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 2008 manual to check the appropriateness of a particular code and for information on additional codes. Merck makes no warranties, 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.

CPT codes are used for billing professional services. Note that the CPT administration code(s) must be reported in addition to the vaccine product code 90680.

Report codes 90467-90468 only when the physician provides face-to-face counseling of the patient and family during the administration of a vaccine. For immunization administration of any vaccine that is not accompanied by face-to-face physician counseling to the patient/family, report codes 90473–90474.

ICD-9-CM codes may be utilized or mandated by payers to describe the viral disease for which the prophylactic vaccination is administered. There is not currently an ICD-9-CM code specific to the rotavirus vaccine (this reflects information available to Merck as of June 2007).

Note that CPT 90474 is expected to apply when more than one vaccine is administered during the same office visit.

For additional information regarding CPT product and administration codes and ICD-9-CM codes concerning RotaTeq, go to the Merck Vaccine Reimbursement Support Center (MVRSC) through www.vaccinesupportservices.com or call the MVRSC directly at 1-800-REIMBVAX (1-800-734-6282).

^cPhysicians ICD-9-CM © 2008 American Medical Association. All Rights Reserved.

• RotaTeq is indicated for the prevention of rotavirus gastroenteritis in infants and children caused by the serotypes G1, G2, G3, and G4 when administered as a 3-dose series to infants between the ages of 6 to 32 weeks.
• The vaccination series consists of 3 ready-to-use liquid doses of RotaTeq administered orally starting at 6 to 12 weeks of age, with the subsequent doses administered at 4- to 10-week intervals. The third dose should not be given after 32 weeks of age.

Select safety information

• RotaTeq should not be administered to infants with a demonstrated history of hypersensitivity to the vaccine or any component of the vaccine.
• No safety or efficacy data are available for the administration of RotaTeq to infants who are potentially immunocompromised or to infants with a history of gastrointestinal disorders.
• Caution is advised when considering whether to administer RotaTeq to individuals with immunodeficient contacts.
• In clinical trials, the most common adverse events included diarrhea, vomiting, irritability, otitis media, nasopharyngitis, and bronchospasm.
• In post-marketing experience, intussusception (including death) and Kawasaki disease have been reported in infants who have received RotaTeq.
• RotaTeq may not protect all vaccine recipients against rotavirus.

Before administering RotaTeq, please read the Prescribing Information
and Patient Product Information.

RotaTeq is a registered trademark of Merck & Co., Inc.