New COVID-19 Vaccine Codes: October Update

Recently, new Current Procedural Terminology (CPT®) codes for a ready-to-use vaccine product (tris-sucrose formulation) from Pfizer and its administration were added to previously established vaccine codes for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]). 

The CPT Editorial Panel (the Panel) has approved a new vaccine product code and its associated administration codes of the reformulated Pfizer vaccine product for pediatric use. This reformulated vaccine product involves the administration of two intramuscular injections of a diluted and reconstituted dosage of 10 mcg/0.2 mL volume of the tris-sucrose formula, which is administered 21 days apart, for use in patients ages 5 through 11 years of age. As with previous COVID-19 vaccine administration codes, counseling is included as part of the administration visit.

In order to assist CPT code users in differentiating and appropriately reporting the available vaccine product codes and their affiliated immunization administration codes, the American Medical Association (AMA) established a website (https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-vaccine-and-immunization-codes) that features timely updates of the Panel's actions. The last COVID-19 update was in the CPT® Assistant Special Edition: September Update (2021) in which the Pfizer and Moderna third-dose vaccine administration codes (0003A, 0013A); Pfizer's ready-to-use vaccine product code (91305) and its associated administration codes (0051A, 0052A, 0053A); Moderna's lower-dose vaccine product code (91306) and associated booster-dose administration code (0064A); and booster-dose administration codes for the Pfizer vaccine product (0004A, 0054A) were established.

This issue of CPT® Assistant Special Edition introduces and provides guidance on the appropriate use of the new pediatric Pfizer vaccine product code (91307) for use in patients ages 5 through 11 years of age and its associated new administration codes (0071A, 0072A). 

(Report 0001A, 0002A, 0003A, 0004A for the administration of vaccine 91300.  Do not report 0001A, 0002A, 0003A, 0004A in conjunction with 91305, 91307.)

(Report 0051A, 0052A, 0053A, 0054A for the administration of vaccine 91305.  Do not report 0051A, 0052A, 0053A, 0054A in conjunction with 91300, 91307.)

(Report 0071A, 0072A for the administration of vaccine 91307.  Do not report 0071A, 0072A in conjunction with 91300, 91305.)

Vaccines, Toxoids


Source: https://www.ama-assn.org/system/files/cpt-assistant-guide-coronavirus-october-2021.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=name_coding_covid_vaccine_updates_doj_largest_settlement_of_its_kind&utm_term=2021-10-22