NDCs will help you determine when to use 0094A and 91309.
If you’ve been waiting for news on Moderna’s booster dose-specific COVID-19 vaccine for adults, check this out: The Food and Drug Association (FDA) revised the emergency use authorization (EUA) to include this booster as of March 29, 2022.
Assign 0094A, 91309 for Booster Dose
Not surprisingly, a new COVID-19 vaccine product means new codes. The American Medical Association (AMA) announced the codes back on March 7, 2022, stating the codes would be effective upon receiving EUA. The CPT® codes are specific to a 50 mcg/0.5 mL booster dose:
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
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
Code 0094A represents the administration and 91309 represents the vaccine product. “As with previous COVID-19 vaccine administration codes, counseling is included as part of the administration visit and should not be reported separately,” states AMA’s 2022 CPT® Assistant Special Edition: March Update.
The intent behind these codes is to offer specific reporting options for Moderna’s booster dose-specific COVID-19 vaccine for patients 18 and older, according to CPT® Assistant.
Avoid Confusion With Other Moderna Booster Codes
To ensure you use new codes 0094A and 91309 properly, you must distinguish them from two other Moderna COVID-19 booster codes, which were effective Oct. 20, 2021: 0064A and 91306. The descriptors for those codes are identical to the new codes except for the dosage amounts:
0064A, 91306: 50 mcg/0.25 mL dosage
0094A, 91309: 50 mcg/0.5 mL dosage
CPT® Assistant explains that the new codes (0094A, 91309) represent a product using a 50 mcg/0.5 mL dosage concentration and delivered in new booster dose-only packaging. The goal of having this booster-specific packaging is to support safety, making it simpler to administer the correct booster dose. Before the creation of this packaging, providers pulled the booster dose from primary dose vials with a 100 mcg/0.5 mL dose.
Be careful to report the correct administration and product code pairs together. For instance, when 91309 is the correct supply code, be sure to report 0094A as the administration code. Official notes with the codes will help you find the correct code combinations to report.
Use NDCs to Support Proper Coding
To help you code accurately, you can use the National Drug Codes (NDCs) associated with the products. You can check the product packaging, AMA Appendix Q, and Medicare’s NDC-HCPCS crosswalk for NDCs related to the product and supply code. Here are examples of what you can expect to see:
91306: 80777-273-10, 80777-0273-10, 80777-0273-99, 80777-0273-98
91309: 80777-275-05, 80777-0275-05 (91309 was not in the NDC-HCPCS crosswalk at the time of publication)
For More Information: https://www.aapc.com/blog/84727-confirm-dosage-for-new-covid-19-booster/
