Category: COVID19

The American Medical Association (AMA) has issued new Current Procedural Terminology (CPT) codes for pediatric doses of the Pfizer COVID-19 vaccine. In September 2021, Pfizer and BioNTech shared the results of a Phase 2/3 clinical trial in which two doses of the vaccine elicited a strong immune response in children ages 5 to 11. Following the trial, the companies submitted the data to the Food and Drug Administration (FDA). Pfizer recently announced that they have submitted a formal request to the FDA for emergency use authorization of their COVID-19 vaccine in children ages 5 to 11. In…

New HCPCS Codes for COVID-19 Treatments On June 24, the Food and Drug Administration (FDA) released an Emergency Use Authorization for tocilizumab (Actemra), a monoclonal antibody product used for the treatment of COVID-19. Providers should use the following new HCPCS Level II codes when billing this product: Q0249     Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, 1 mg M0249    Intravenous infusion, tocilizumab, for hospitalized…

The AMA released a series of codes that would be eligible for reporting a COVID-19 vaccine under development by Novavax Inc. While the Novavax vaccine has yet to gain clearance from the U.S. Food and Drug Administration, the Gaithersburg, Md.-based biotechnology company has accelerated its testing and development and plans to ship hundreds of millions of products to the European Union later in the year. Like other vaccine developers, the company also is expanding its testing of the vaccine to younger age groups, including children between the ages of 12 to 17. The AMA code update, which includes…

ICD-10 may be moving to biannual updates —April 1, in addition to October 1—depending on public comment . CMS and CDC jointly announced that the possibility of a regular April 1 update to ICD-10 is under consideration. CMS is taking the lead in the discussion and collection of public comment.  By law, the current use of April 1 for an interim implementation of new ICD-10 codes is highly constrained—emerging diseases and qualifying NTAP (New Technology Add-on Payment) proposals only. As far as I know we have never had an April…

The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, bamlanivimab and etesevimab, administered together, for the treatment of mildto-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization. Bamlanivimab and etesevimab, administered together, may only be administered in settings in which health care providers have immediate access to medications to treat a severe infusion reaction, such as anaphylaxis, and the ability to activate the Emergency Medical System…

The American Medical Association (AMA) today announced that the Current Procedural Terminology (CPT®) code set is being updated by the CPT Editorial Panel to include vaccine and administration codes that are unique to the COVID-19 vaccine candidate under development by Janssen Pharmaceutica, a division of Johnson & Johnson. The new CPT codes will be effective for use on the condition that the Janssen COVID-19 vaccine receives approval or emergency use authorization from the Food and Drug Administration (FDA). The AMA is publishing the new CPT codes now to ensure electronic systems across…