New COVID-19 Vaccine Code 0034A Coding Guidelines

The CPT Editorial Panel has approved a new vaccine administration code (0034A) for the administration of the Janssen COVID-19 vaccine booster for patients who had previously received the Janssen single-dose primary vaccine.

Immunization Administration for Vaccines/Toxoids

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/0.5 mL dosage; single dose

0034A booster dose

(Report 0031A, 0034A for the administration of vaccine 91303)

Vaccines, Toxoids

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/0.5 mL dosage, for intramuscular use

(Report 91303 with administration codes 0031A, 0034A)

The booster dose is identical in volume and concentration to the initial single-dose vaccine product. The booster dose is intended for use in patients ages 18 or older, and it may be administered 2 months or later following the initial dose. The Janssen vaccine product is still a single-dose regimen, even though it now has a booster dose that is available for patients who meet the criteria and require a booster. The physician or other qualified health care professional (QHP) should exercise his or her clinical judgment to determine whether the booster dose is appropriate for a given patient.

Read also: COVID-19 related ICD-10 diagnosis and CPT codes

Clinical Example (0034A)

A 33-year-old individual, who was previously immunized with a primary series, seeks booster  immunization against SARS-CoV-2 to decrease the risk of contracting this disease, consistent with evidence-supported guidelines. The individual is offered and accepts an intramuscular injection of SARS-CoV-2 vaccine for this purpose.

Read also:

https://www.ama-assn.org/system/files/cpt-assistant-guide-coronavirus-november-2021.pdf

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