March New Update on COVID-19 Vaccine Codes

The CPT Editorial Panel (the Panel) has approved a new vaccine product code (91309) and its associated vaccine administration code (0094A) for the Moderna booster dose–specific COVID-19 vaccine product for adult patients aged 18 years and older, which will become effective upon receiving the emergency use authorization (EUA) approval from the Food and Drug Administration (FDA)

Immunization Administration for Vaccines/Toxoids

0094A 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/0.5 mL dosage, booster dose
(Report 0094A for the administration of vaccine 91309)
(Do not report 0094A in conjunction with 91301, 91306)

91309 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use
(Report 91309 with administration code 0094A)
(Do not report 91309 in conjunction with administration codes 0011A, 0012A, 0013A, 0064A)

Clinical Example (91309)
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.

Description of Procedure (91309)
The physician or other qualified health care professional (QHP) determines that the SARS-CoV-2 vaccine is appropriate for this patient and dispenses the booster vaccine according to the dose scheduled in the administration code for the SARS-CoV-2 vaccine.

Clinical Example (0094A)
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.

Description of Procedure (0094A)
The physician or other QHP reviews the patient’s chart to confirm that vaccination to decrease the risk of COVID-19 is indicated. Counsel the patient on the benefits and risks of vaccination to decrease the risk of COVID-19 and obtain consent. Administer the booster dose of the COVID-19 vaccine by intra-muscular injection in the upper arm. Monitor the patient for any adverse reaction. Update the patient’s immunization record (and registry when applicable)
to reflect the vaccine administered.

Reference:

https://www.ama-assn.org/system/files/cpt-assistant-guide-coronavirus-march-2022.pdf

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