ipopba - stock.adobe.com

AMA Unveils CPT Codes for Third Dose of Pfizer COVID-19 Vaccine

AMA announced an updated CPT code specific to a potential third dose of Pfizer’s COVID-19 vaccine in the event that the FDA authorizes an additional dose.

The American Medical Association (AMA) unveiled a new Current Procedural Terminology (CPT) code for a potential third dose of Pfizer’s COVID-19 vaccine. The AMA chose to publish the code in advance to ensure that healthcare systems will be prepared if the Food and Drug Administration (FDA) authorizes an additional dose in the future, the announcement stated.

Quarterly earnings data from Pfizer suggest that a third dose of the Pfizer/BioNTech COVID-19 vaccine may be necessary to combat the extremely contagious Delta variant. Pfizer’s data shows that Delta may be responsible for about 83 percent of current US COVID-19 cases.

“The FDA and the U.S. Centers for Disease Control and Prevention (CDC) have analyzed data indicating that at this time individuals do not need to exceed the standard two doses authorized for Pfizer’s COVID-19 vaccine,” Gerald Harmon, MD, AMA president, explained in the announcement.

“The AMA supports the position of the CDC and FDA since it is based on a careful consideration of the available evidence to date. We are confident that federal health agencies will continue to review emerging evidence on a potential third dose of the Pfizer COVID-19 vaccine. The CPT code set stands ready to meet the immediate needs of the health system if third dose shots are considered necessary.” 

The CPT codes will be used to report the administration of the vaccine and assist with updating patient electronic health records.

Pfizer’s initial analysis suggested that its booster dose led to significantly higher antibody levels against the Delta variant. But HHS, FDA, and CDC agreed that a booster shot is not needed at this time, according to a July 8th announcement.

“FDA, CDC, and NIH are engaged in a science-based, rigorous process to consider whether or when a booster might be necessary. This process takes into account laboratory data, clinical trial data, and cohort data – which can include data from specific pharmaceutical companies, but does not rely on those data exclusively,” the announcement articulated.

“We continue to review any new data as it becomes available and will keep the public informed. We are prepared for booster doses if and when the science demonstrates that they are needed.”

However, as the Delta variant takes hold, CDC guidance may continue to evolve. Fully vaccinated people should once again wear masks in public indoor settings in areas with high or substantial transmission, the CDC announced on July 28th.

In addition, CDC recommended that teachers, students, and school staff should wear masks regardless of vaccination status.

Pfizer cited “ongoing discussions with regulatory agencies” and said that it may submit an emergency use authorization (EUA) application as early as August. Pfizer said it manufactured the first batch, and clinical studies will likely begin in August if approved.

The official vaccine administration CPT code and long descriptor for the third dose of the Pfizer COVID-19 vaccine is as follows:

0003A: 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; third dose

More guidance and information on CPT codes for COVID-19 can be found here.

Next Steps

Dig Deeper on Medical billing and collections

xtelligent Health IT and EHR
xtelligent Patient Engagement
xtelligent Virtual Healthcare
Close