AMA Releases 2022 CPT Code Set For COVID-19 Vaccines

In a recent development_ the American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set for 2022. The new CPT code set is being launched in order to streamline the medical coding processes as well as documentation of COVID-19 vaccinations.

The updates include vaccine and administration codes. That is unique to a new formulation of the COVID-19 vaccine developed by Pfizer. According to the authority, the provisional CPT codes will be effective for use on the condition that tris-sucrose formulation of Pfizer’s COVID-19 vaccine receives approval or emergency use authorization from the U.S. Food and Drug Administration (FDA). The Association developed CPT codes are:

Pfizer Vaccine Code (tris-sucrose formulation)

91305: 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, tris-sucrose formulation, for intramuscular use

Pfizer Administration Codes (tris-sucrose formulation)

0051A: 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, tris-sucrose formulation; first dose

0052A: 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, tris-sucrose formulation; second dose.

0053A: 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, tris-sucrose formulation; the third dose.

In order to stand strong against the COVID-19, the trend of booster shots has gained pace, particularly in the United States. Therefore, the CPT Editorial Panel of the AMA has also approved the provisional CPT codes for booster doses of COVID-19 vaccines created by Moderna and Pfizer.

It’s pertinent to mention here that: Pfizer booster is likely to remain the same dose as the existing formulation. On the other hand, the Moderna booster is administered at a different dose from the existing formulation. Due to this factor, the authorities have created a new vaccine code for the booster shot of the Moderna.

Moderna Booster Code

91306: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 50 mcg/0.25 mL dosage, for intramuscular use

Moderna Booster Administration Code

0064A: 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, 50 mcg/0.25 mL dosage, booster dose

Pfizer Booster Administration Codes (Original Formulation and Tris-Sucrose)

0004A: 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; booster dose

0054A: 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, tris-sucrose formulation; booster dose

Be Prepared in Advance

In an official statement, the American Medical Association has made it clear that: the updated CPT codes are being published earlier to give an intimation to the healthcare providers across the United States. So they can prepare their electronic systems in advance for the potential FDA approval or authorization of the tris-sucrose formulation of Pfizer’s COVID-19 vaccine.

Earlier, the authorities have also issued unique CPT codes for COVID-19 vaccines from AstraZeneca, Janssen (Johnson & Johnson), Moderna, Novavax and Pfizer’s original formulation. The detailed information including short, medium, and long descriptors for all the new COVID-19 vaccine CPT codes are available on AMA’s website.

As the field of medical coding and billing is witnessing constant evolutions. Medical practitioners should take appropriate measures to keep pace with the ever-evolving healthcare industry. More importantly, they should conduct special training sessions for their medical billing and coding staff. In this way, they stay at the top of the most recent billing and coding guidelines. And become better able to prepare the medical claims with accurate information. Which ultimately results in the maximum reimbursements.

Moreover, it is also the responsibility of the healthcare practitioners to ensure the availability of the updated manual books for CPT, HCPCS and ICD-10 codes. Because failure to process the medical claims with outdated or deleted medical codes ultimately results in claim denials and eventually in revenue loss. Additionally, healthcare providers should always get ready to deal with the other healthcare changes to stay ahead of the competitors.

Do you find this article useful? Then stay tuned with the Medical Billing Benefits for more updated and detailed healthcare reforms. It is the most authentic healthcare newswire that never let its reader lag behind the latest updates in the medical industry. For more such articles on medical billing services and technology, subscribe to our news feed.

Read Previous

CMS Delays Enforcement of Price Transparency Non-Compliance Penalties

Read Next

Healthcare Providers All Set to Receive $25.5 Billion in COVID-19 Relief Funds

Leave a Reply

Your email address will not be published. Required fields are marked *