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AMA Updates CPT Codes for COVID-19 Vaccines

The updates embody distinctive CPT codes for a brand new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses anticipated to roll out later this month.

The American Medical Affiliation (AMA) has introduced updates to the Present Procedural Terminology (CPT) code set to account for adjustments to COVID-19 vaccines, together with booster pictures anticipated to rollout later this month.

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The updates additionally embody distinctive CPT codes for the vaccine and administration of a brand new formulation of the COVID-19 vaccine developed by Pfizer. The brand new formulation makes use of a tris-sucrose buffer as an alternative of the phosphate buffer used within the unique formulation, AMA defined. Subsequently, the Affiliation developed CPT codes:

  • 91305: Extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
  • 0051A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; first dose
  • 0052A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; second dose
  • 0053A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; third dose

The codes are for using the tris-sucrose formulation of Pfizer’s vaccine as soon as it acquired emergency use authorization or full approval from the Meals and Drug Administration (FDA).

FDA has already granted Pfizer’s unique formulation full approval and has approved the emergency use authorization for the vaccine to incorporate a 3rd dose, or booster shot. The White Home plans to rollout a 3rd dose of the Pfizer COVID-19 vaccine by Sept. 20. CPT code 0053A will likely be obtainable to doc the booster pictures for the brand new formulation of Pfizer’s vaccine.

Booster pictures for the opposite mRNA-based vaccine from biotechnology firm Moderna are additionally anticipated, however later than the third doses of Pfizer, in line with nationwide new sources.

Moderna’s COVID-19 vaccine has but to obtain full FDA approval for its COVID-19 vaccine. Nonetheless, FDA has altered the emergency use authorization to permit for a 3rd dose of the vaccine. President Biden’s Chief Medical Adviser Anthony Fauci stated over the weekend that Moderna has not submitted knowledge on the efficacy of a booster shot, which Pfizer already has. In consequence, the White Home will unlikely rollout booster pictures for each vaccines on the identical time.

If the third dose of Trendy’s COVID-19 vaccine is permitted by the FDA, then immunizers may have CPT codes to doc these doses. In preparation for booster pictures, AMA introduced CPT codes:

  • 91306: Extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use
  • 0064A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, booster dose

AMA famous that, not like the Pfizer booster dose, the booster dose of Moderna’s vaccine is more likely to be administered at a unique dose from the present formulation.

“For that reason, a brand new vaccine code was created for the Moderna booster vaccine. These provisional CPT codes will likely be efficient to be used on the situation that booster doses of the COVID-19 vaccines created by Moderna and Pfizer obtain approval or authorization from the FDA,” the Affiliation acknowledged within the announcement.

The up to date CPT code set additionally consists of:

  • 0004A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; booster dose
  • 0054A: Immunization administration by intramuscular injection of extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus illness [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; booster dose

Brief, medium, and lengthy descriptors for all the brand new COVID-19 vaccine CPT codes can be found on AMA’s web site. Suppliers can even entry different pandemic-related modifications to the CPT code set utilizing that hyperlink.

For Extra Info: https://revcycleintelligence.com/information/ama-updates-cpt-codes-for-covid-19-vaccines

 

 

 

 

 

 

 

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