CPT Codes for COVID-19 Vaccination

Updated: Jun 28



AMA approved a unique CPT code for COVID-19 Vaccination and administration codes to facilitate the tracking of vaccines administered.


The AMA CPT Editorial Panel has approved a unique CPT code for each of two COVID-19 vaccines and administration codes unique to each COVID-19 vaccine on November 10, 2020. The new CPT codes clinically distinguish each coronavirus vaccine for better tracking, reporting, and analysis that supports data-driven planning and allocation. These codes are effective immediately based upon Emergency use authorization approval from the Food and Drug Administration.


CPT Codes for COVID-19 vaccine


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 dosages, diluent reconstituted, for intramuscular use. (This COVID-19 vaccine is manufactured by Pfizer)

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 dosages, for intramuscular use.


With the release of these specific CPT codes for vaccines, the CPT Editorial Panel has worked with the Centers for Medicare and Medicaid Services (CMS) to create new vaccine administration codes that are both distinct to each coronavirus vaccine and the specific dose in the required schedule


Now, let’s look at the new vaccine administration CPT codes as well as their descriptions.


Administration CPT codes


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 dosages, 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 dosages, 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 dosages; 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 dosages; second dose.

All the new vaccine-specific CPT codes published in today’s update will be available for use and effective upon each new coronavirus vaccine receiving Emergency Use Authorization or approval from the Food and Drug Administration.


Now, the important concern is these new codes and their descriptors will need to be manually uploaded into EHR and other health systems because they are not reflected in the 2020 or 2021 CPT codebook.]


SARS-CoV-2 related CPT codes


SARS-CoV-2 related CPT codes that have been approved and published for the 2021 CPT code set are given below:

  • 87635-Report infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique. The new code was effective March 13, 2020.

  • 86318 -Report immunoassay for infectious agent antibodies and to be a parent to 86328; addition of code 86328 to report single step antibody testing for severe acute respiratory syndrome coronavirus 2; addition of child code 86769 to report multiple-step antibody testing for severe acute respiratory syndrome coronavirus 2; and revision of the Immunology guidelines. The new codes and revision were effective April 10, 2020.

  • Accepted the addition of PLA code 0202U to report the BioFire® Respiratory Panel 2.1 (RP2.1) test. The new code was effective May 20, 2020.

  • Accepted addition of code 87426 to report infectious agent antigen detection by immunoassay technique of SARS-CoV and SARS-CoV-2. Also, two new PLA codes (0223U and 0224U) were accepted for detection of SARS-CoV-2.

  • Accepted addition of codes 86408 for reporting coronavirus 2 (SARS-CoV-2) neutralizing antibody screen and 86409 for reporting coronavirus 2 (SARS-CoV-2) neutralizing antibody titer. Also, two new PLA codes (0225U and 0226U) were accepted for detection of SARS-CoV-2. These new codes are effective Aug. 10, 2020.

  • Accepted addition of code 99072 for the additional supplies and clinical staff time required to mitigate transmission of respiratory infectious disease while providing evaluation, treatment, or procedural services during a public health emergency, as defined by law. Also, one code, 86413, was created for reporting quantitative antibody detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

  • Accepted addition of code 87636 for reporting combined respiratory virus multiplex testing for either SARS-CoV-2 with Influenza A&B, code 87637 for combined respiratory virus multiplex testing for either SARS-CoV-2 with Influenza A&B and RSV, and 87811for antigen detection of SARS-CoV-2 by direct optical (i.e., visual) observation. Two new PLA codes (0240U and 0241U) were accepted for detection of SARS-CoV-2, Influenza A, and Influenza B; code 0241U also detects RSV. Additionally, Immunology guidelines were also revised, along with codes 87301, 87802 and their subsidiary codes.

  • Accepted addition of two Category I codes to report SARS-CoV-2 vaccine and immunization administration codes. Codes 91302, 0021A, and 0022A are used to report the AstraZeneca COVID-19 vaccine these codes were published on December 17, 2020, and will be effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration.

  • Accepted addition of code 87428 for reporting multiplex viral pathogen panel using antigen immunoassay technique for SARS-CoV-2 testing along with influenza A and influenza B.

  • Accepted addition of codes addition of six Category I codes to report SARS-CoV-2 vaccine and immunization administration codes. Codes 91300, 0001A, and 0002A are used to report the Pfizer-BioNTech. COVID-19 vaccine and 91301, 0011A, and 0012A are used to report the Moderna COVID-19 vaccine. These codes were published on November 10, 2020, and will be effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration.

  • Accepted addition of one Category I code to report SARS-CoV-2 vaccine and immunization administration codes. Codes 91303, 0031A are used to report the Janssen COVID-19 vaccine. These codes were published on January 19, 2021, and will be effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration.

X-Factor Healthcare Solutions LLC is an experts in medical billing and coding and we are your partner during these challenging times. Our professionals are up-to-date on the coronavirus codes and can ensure that your practice gets paid for the services you’re providing to patients.

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