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COVID coding shake-up: AMA consolidates vaccine, admin codes; CMS approves

Make sure you're staying accurate with an overhaul to the COVID-19 vaccine and administration codes. The AMA announced it is deleting a significant number of codes, replacing them with new codes and striking Appendix Q from the CPT Manual.
Based on recent guidance from the Food and Drug Administration (FDA) to pivot to a monovalent vaccine structure, the AMA has approved a series of three codes, 91318, 91319 and 91320, for the Pfizer monovalent vaccines and two codes, 91321 and 91322, for the Moderna monovalent vaccines, the organization explained in a special edition of CPT Assistant.
The AMA approved the new codes in August, and CMS granted them effective for Medicare payment as of Sept. 11, 2023. All previously approved codes, with one exception, will be deleted effective Nov. 1, 2023. The lone exception is code 91304, which corresponds to the Novavax vaccine.
Your matching administration codes will get a lot easier to figure out, as well. All previously approved administration codes are being deleted with the same Nov. 1 effective date, and they are replaced with a single code, 90480, which also takes a Medicare-effective date of Sept. 11. The new administration code is "approved for reporting the administration of any COVID-19 vaccine for any patient (pediatric or adult), replacing all previously approved specific vaccine administration codes," the AMA states in the special edition.
That means all codes ending with an "A" are no longer covered and will be deleted effective Nov. 1.
New administration code 90480 pays at the same $40 amount as the previously reportable codes. You can find the CMS-approved update, including effective dates, here.
If you're planning to purchase the 2024 CPT Manual, you'll still find Appendix Q in there but you can consider it gone.
Blog Tags: AMA, CMS, COVID-19
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