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Coding via the
Medical Encounter Form

Medical encounter forms (aka the superbill, fee ticket, or routing slip) are used to assist in billing for patient visits. Encounter forms may be printed or in electronic format as part of an electronic medical record (EMR). These forms generally include the following information [10]:

TIP Remember to record all immunization-related services to ensure proper reporting. Ensure that forms (paper or electronic) are up-to-date with all available ICD-10 and CPT codes.

826034R0 October 2017

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.

You are encouraged to report vaccine adverse events to the US Department of Health and Human Services.
Visit to file a report, or call 1-800-822-7967.

To learn more about the
GSK Vaccines Access Program,
click here.
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