News: Promising COVID-19 vaccines and new CPT codes

Two pharmaceutical companies release positive efficacy results related to COVID-19 vaccinations.

Pfizer announced efficacy has been rated above 90% at seven days after the second dose, meaning protection is achieved 28 days after the initiation of the two-dose vaccine. Thus far, no serious safety concerns have been reported, and the data monitoring committee recommends the study continue to collect additional safety and efficacy data as planned. Moderna meanwhile announced its trial vaccine as having a 95% efficacy rate.

The American Medical Association (AMA) has announced new CPT codes for reporting COVID-19 vaccine products and immunization administration. The new codes, two vaccine product codes and four administration codes, will allow healthcare providers to report and track administration of COVID-19 vaccines once they receive approval or an emergency use authorization from the FDA and will go into effect at that time.

The codes, linked to the Pfizer and Moderna vaccine candidates, are:

• 91300, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted, for intramuscular use
  • Vaccine manufacturer: Pfizer Inc.

• 91301, SARS-CoV-2 (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, for intramuscular use
  • Vaccine manufacturer: Moderna Inc.

Each vaccine product code is linked with a pair of vaccine administration codes, which correspond to first and second doses.

For the 91300-product code, providers would report:

• 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/0.3 mL dosage, diluent reconstituted; first dose
• 0002A, …; second dose

For the 91301-product code, providers would report:

• 0011A, immunization administration by intramuscular injection of SARS-CoV-2 (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage; first dose
• 0012A, …; second dose

The AMA says that it is critical that the codes “are available prior to the public availability of the vaccines to facilitate updating of healthcare electronic systems across the U.S.”

Editor’s note: The Pfizer vaccine press release can be found here. The Moderna vaccine press release can be found here. The AMA CPT codes can be found here. The CPT code portion of this article was adapted from an article originally published in Revenue Cycle Advisor.