While the world waits on a vaccine for the novel coronavirus, a CPT code update containing a suite of six vaccine product and administration codes offers reason to ready your claims reporting systems.
In
the Nov. 10 code release, the American Medical Association put forth two vaccine product codes and four vaccine administration codes, which are expected to become effective at a future date. The codes “will be available for use and effective upon each new coronavirus vaccine receiving Emergency Use Authorization or approval from the Food and Drug Administration,” the AMA states.
The CPT Editorial Panel, working with the CDC, approved a “unique CPT code for each of two coronavirus vaccines,” which the AMA says will aid in providing data about the spread and incidence of COVID-19, according to the statement. The two vaccine codes are linked to products manufactured by Pfizer Inc. and Moderna Inc., respectively.
The two vaccine product codes, with full descriptors, are:
- 91300 (Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use)
- 91301 (Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use)
Each of the vaccine product codes is linked with a pair of vaccine administration codes, which correspond to first and second doses. A
special edition of CPT Assistant details how you would report the product and administration codes together.
For the 91300 product code, you would report:
- 0001A (Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose)
- 0002A (Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose)
For the 91301 product code, you would use:
- 0011A (Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose)
- 0012A (Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease [COVID-19]] vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose)
The AMA says that it’s critical that the codes “are available prior to the public availability of the vaccines to facilitate updating of health care electronic systems across the U.S.”
You’ll also find a new appendix in the CPT code set.
Appendix Q contains the new vaccine product and administration codes, along with dosing schedules and drug manufacturer.