• COVID-19 vaccine CPT codes just keep coming

    Last week, the American Medical Association (AMA) announced an editorial update to Current Procedural Terminology (CPT) that includes newly assigned provisional CPT codes for COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline (GSK). The Pfizer booster candidate is proposed for use in children ages 5 to 11 who have completed a COVID-19 vaccine primary series, while the Sanofi-GSK booster candidate is proposed for use in persons ages 18 and older who have completed a COVID-19 vaccine primary series. Each provisional CPT code is effective for use on the condition that its assigned booster candidate is granted an Emergency Use Authorization by the U.S. Food and Drug Administration.

    The new product code and administration codes assigned to each COVID-19 booster candidate are as follows.

    Product and administration codes for Sanofi-GSK booster candidate:

    91310    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative-free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, for intramuscular use.

    0104A    Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative-free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, booster dose.

    Administration code for Pfizer booster candidate:

    0074A    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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; booster dose.

    (The above administration code is to be reported with vaccine product code 91307 when a booster dose of the Pfizer vaccine is administered to pediatric patients ages 5 to 11.)

    For more information, please see the April special edition of CPT Assistant and the AMA’s COVID-19 CPT vaccine and immunization codes web page.

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

    Posted on May 6, 2022, by Kent Moore



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