AMA updates CPT code set for avian influenza vaccines

The American Medical Association (AMA) recently announced an update to its Current Procedural Terminology (CPT) code set to account for the development and administration of avian influenza vaccines.

A recent outbreak of the avian influenza, or bird flu, through the strain H5N1 has spread globally in wild birds, infecting poultry, dairy cows and other mammals, including humans.

According to the CDC, there have been 11 cases reported in humans in the US. Of these cases, five have been confirmed as the latest strain H5N1.

In response, the AMA has provided a provisional CPT code to document H5N8 influenza virus vaccine candidates that have received emergency use authorization from the FDA. The new product code (quick description) assigned to the vaccines is:

90695: Influenza virus vaccine, H5N8, derived from cell cultures, adjuvanted for intramuscular use

AMA said on its website the CPT code should be used with an administration code to report the work counseling patients or caregivers, administering the vaccine and updating the medical record. Those codes from the website include, but may not be limited to:

For children (through 18 years of age)

90460: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered

90461: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered

For adults

90471: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)

90472: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid)

The update to the CPT code set has been updated to prepare EHR systems in the US for the potential FDA authorization of bird flu vaccines, according to the AMA.

The US government has already ordered over 4.8 million doses of a pre-pandemic cell-based vaccine from CSL Seqirus that is well matched to the current strain circulating globally. Additionally, HHS, through the Biomedical Advanced Research and Development Authority, recently provided $176 million to Moderna to develop an mRNA-based vaccine to counter this outbreak of the bird flu.

“The new CPT code is a vital preparatory step in response to the potential danger to humans from a highly infectious avian influenza disease,” AMA President Bruce A. Scott, MD, said in an announcement. “A CPT code that clinically distinguishes the avian influenza vaccine allows for data-driven tracking, reporting and analysis that supports planning, preparedness, and allocation of vaccines in case a public health response is needed for avian flu prevention.”

For guidance on new CPT codes and how to use them, please refer to the AMA. Per the trade group, questions on CPT coding and content should be directed to the CPT Network, its authoritative source for CPT coding answers. This article was published on July 22, 2024. Additional CPT codes and guidance on bird flu vaccine documentation may be published following publication of this article.