FWA Briefs

Find news and solutions for healthcare payers and providers. Recognize and avoid potential fraud, waste, and abuse scenarios. Real-time clinical claim editing are analyzed to maximize provider reimbursements.

New COVID-19 Vaccine Codes Released, Effective Pending FDA Approval

  • by Steve Nesnidal, MD, CPC, AHFI
  • Nov 17, 2020, 11:45 AM
COVID Vaccine

AMA has released a series of new, unique CPT Category I codes for use in reporting COVID-19 FDA approved vaccines. The codes will become active as soon as the FDA approves the first two COVID-19 vaccines produced by Pfizer and Moderna.

As is the case with reporting other vaccines, CPT requires one code for the toxoid and a separate code for administering the vaccine. For COVID-19 vaccines, AMA has released a specific code for each toxoid, and a series of vaccine specific administration codes for use in reporting the administration of each distinct dose. Note that the administration code also includes any consultation work necessary to educate the patient about the vaccine.

The two new COVID-19 VACCINE TOXOID CPT codes are: 

  • 91300 (Pfizer vaccine toxoid)
  • 91301 (Moderna vaccine toxoid)

The four new COVID-19 VACCINE ADMINISTRATION CPT codes are:

  • 0001A (Administering Pfizer vaccine, first dose)
  • 0002A (Administering Pfizer vaccine, second dose)
  • 0011A (Administering Moderna vaccine, first dose)
  • 0012A (Administering Moderna vaccine, second dose)

Vaccine Doses and Code Use

The Pfizer vaccine will require two doses given 21 days apart, while the Moderna vaccine will require two doses 28 days apart. Examples on applying codes are listed below:

  • The second Pfizer COVID-19 vaccine dose administered by the provider who also supplies the toxoid will report 91300, 0002A
  • The first Moderna COVID-19 vaccine dose administered by the provider who also supplies the toxoid will report 91301, 0011A

Many other COVID-19 vaccines are in current trials and also show promise. Any additional CPT toxoid and administration COVID-19 codes that are approved going forward in this Emergency Period will likely follow a similar format and release approach. Considering vaccination for COVID-19 will need to span the majority of 7.8 billion people of Earth, the more effective vaccine products, the better!

Context4 Healthcare Stays Informed

Context4 Healthcare staff will continue to monitor for new CPT toxoid and administration codes and inform our clients with the latest up-to-date code information in the COVID-19 Emergency Period.

Load more comments
comment-avatar

Subscribe to Our Blog:

Connect With Us

Authors


Proudly Affiliated with:

Proud_Members_Logo_250X100   National Association of Dental Plans Member   FedRAMP  Amazon Web Services