AMA Updates CPT Code Set to Include COVID-19 Vaccine Codes

The American Medical Association (AMA) has added several COVID-19 vaccine codes to the Current Procedural Terminology (CPT) code set so providers can report immunizations for the novel coronavirus.

The CPT Editorial Panel recently approved a unique CPT code for each of two COVID-19 vaccines, the organization announced yesterday. The new codes and their long descriptors are as follows:

• 91300: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use
• 91301: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use

The codes are Category I CPT codes and also have administration codes unique to them.

The administration codes were developed in conjunction with CMS to enable more granular reporting and tracking of vaccine doses, even when providers administer the vaccine for free. The administration codes will also account for the necessary counseling provided to patients or caregivers and updating the electronic health record, AMA stated.

The administration CPT codes and their long descriptors are as follows:

• 0001A: 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/0.3mL dosage, diluent reconstituted; first dose
• 0002A: 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/0.3mL dosage, diluent reconstituted; second dose
• 0011A: 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, 100 mcg/0.5mL dosage; first dose
• 0012A: 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, 100 mcg/0.5mL dosage; second dose

The Category I codes will be effective when each new COVID-19 vaccine receives approval or an emergency use authorization from the FDA, AMA added. At that point, providers will need to upload the codes manually per standard early release procedures.

Overall, the organization believes the unique codes will enable better tracking, reporting, and analysis of immunization efforts.

“An effective national immunization program is key to bringing the coronavirus pandemic to an end,” Susan R. Bailey, MD, president of the AMA, said in the announcement. “Correlating each coronavirus vaccine with its own unique CPT code provides analytical advantages to help track, allocate and optimize resources as an immunization program ramps up in the United States.”

Pfizer announced earlier this week that the mRNA-based COVID-19 vaccine it is developing with BioNTech is over 90 percent effective in preventing the novel coronavirus in certain patients. The company got the data from a Phase 3 clinical trial.

The company is continuing to gather safety data, but it stated in the announcement that it expects the necessary safety data for an emergency use authorization to be available by the third week of November. When the company has the safety and manufacturing data, it will submit the vaccine to the FDA for emergency use in patients.

About 50 million vaccine doses are expected in 2020, with that number ramping up to 1.3 billion doses by next year, Pfizer reported.

The company seems to be the furthest along with developing an effective COVID-19 vaccine. However, other major pharmaceutical companies, including Regeneron, AstraZeneca, and Johnson & Johnson, have also recently released positive results from ongoing trials of their COVID-19 vaccines.