• How to code patients' second COVID-19 booster shots 

    The Centers for Disease Control and Prevention now recommends that people over 50 and those who have certain immunocompromising conditions receive a second mRNA booster shot for COVID-19 if it has been at least four months since their previous dose. But what CPT code should you report for these shots?

    Up until now, each dose of mRNA COVID-19 vaccine came with its own administration code. That’s not the case with the second booster. You should use the same administration code for each booster dose, whether it’s the patient’s first or second.

    For example, if you administer a second booster of the Pfizer vaccine (CPT code 91300) you would report administration code 0004A, “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/0.3 mL dosage, diluent reconstituted; booster dose.”

    As you can see, the descriptor for code 0004A simply refers to “booster dose” and does not specify first or second. As such, it may be used for either booster, and it’s the same for the other COVID-19 vaccines. 

    — Kent Moore, senior strategist for physician payment, American Academy of Family Physicians

    Posted on April 12, 2022, by Kent Moore

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.