What’s the news: The AMA has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations for the new coronavirus, SARS-CoV-2.
Working closely with the Centers for Disease Control and Prevention, the CPT Editorial Panel has approved a unique CPT code for each of three coronavirus vaccines as well as administration codes unique to each such vaccine. The first two, for the Pfizer-BioNTech and Moderna vaccines, were published in November. The third, published this month, is for the vaccine under development by AstraZeneca and the University of Oxford.
The new CPT codes clinically distinguish each coronavirus vaccine for better tracking, reporting and analysis that supports data-driven planning and allocation. The CPT codes are available prior to the public availability of the vaccines to facilitate the updating of health care electronic systems across the U.S.
Find out more with the AMA about COVID-19 and vaccine development, and find answers to patients’ and physicians’ frequently asked questions about coronavirus vaccination.
Why it’s important: “A mass vaccination effort with the first available COVID-19 vaccines presents enormous logistical challenges,” said AMA President Susan R. Bailey, MD. “The ability to correlate each COVID-19 vaccine with its own unique CPT code provides analytical and tracking advantages that ensures optimal vaccine distribution and administration, especially for patients who will need to complete the two-dose immunization schedule.”
For quick reference, the new Category I CPT code and long descriptor for the AstraZeneca vaccine are:
- 91302: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5mL dosage, for intramuscular use
The Category I CPT codes and long descriptors for the Pfizer and Moderna vaccine products 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.
In accordance with the new vaccine-specific product CPT codes, the CPT Editorial Panel has worked with the Centers for Medicare & Medicaid Services to create new vaccine administration codes that are both distinct to each coronavirus vaccine and the specific dose in the required schedule. This level of specificity is a first for vaccine CPT codes, which offers the ability to track each vaccine dose, even when the vaccine product is not reported—for example, when the vaccine may be given to the patient for free.
These CPT codes report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record.
Learn more: All the vaccine-specific CPT codes are available for use and effective upon each new coronavirus vaccine receiving emergency use authorization or approval from the Food and Drug Administration.
Short, medium and long descriptors for the new vaccine-specific CPT codes can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.
Questions on CPT coding and content should be directed to the CPT Network, the authoritative source for CPT coding answers.