The American Medical Association’s CPT® Editorial Panel has released a fourth COVID-19 vaccine code along with a proprietary administration code.
On January 19, 2021, AMA released CPT® code:
91303 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5mL dosage, for intramuscular use.
This vaccine code will not become effective until the Food and Drug Administration (FDA) issues the vaccine product Emergency Use Authorization (EUA) or approval, much like the code for AstraZeneca. Medicare claims processing systems will not accept CPT® code 91202 until that happens.
When the FDA issues the Janssen COVID-19 vaccine EUA or approval, providers will be able to report 91303 with the new administration CPT® code for it:
0031A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5mL dosage, single dose.
New CPT® Medicine Codes for July 1, 2021:
The CPT® Editorial Panel also released an additional five new codes in the Medicine section of the AMA’s CPT® book.
The following codes will be effective July 1, 2021, but will not be published in CPT® books until 2022:
90626 Tick-borne encephalitis virus vaccine, inactivated; 0.25 mL dosage, for intramuscular use
90627 Tick-borne encephalitis virus vaccine, inactivated; 0.5 mL dosage, for intramuscular use
90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use
90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use
90758 Zaire ebolavirus vaccine, live, for intramuscular use
These five codes will be listed out of sequence. Medicare coverage will be determined by the Centers for Medicare & Medicaid Services in the future.