New codes on COVID-19 Vaccine for patients 4 years and below

New-Codes-on-Covid-19-Vaccine

The effective date for 0081A-0083A and 91308 is June 17, 2022.

The Food and Drug Administration (FDA) granted emergency use authorization (EUA) to the Pfizer-BioNTech COVID-19 vaccine for patients ages 6 months to 4 years.

The new CPT® codes for reporting this vaccine are:

0081A 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, 3 mcg/0.2 ml dosage, diluents reconstituted, tris-sucrose formulation; first dose

0082A … second dose

0083A … third dose

91308   Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) (corona virus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 3 mcg/0.2 ml dosage, diluents reconstituted, tris-sucrose formulation, for intramuscular use

Remember that for vaccines, you report one code for the vaccine product supply and another code for the administration. For the new codes, you’ll use 0081A, 0082A, and 0083A for administration of the first, second, and third doses respectively. For the vaccine supply, you will report 91308.

Caution: The new codes are specific to Pfizer’s tris-sucrose formulation with a 3 mcg/0.2 ml dosage. The CPT® code set includes other codes (91305 and 91307) for tris-sucrose formulation products with different dosages. Be sure to use the correct supply code based on the specific product, and use the administration codes created to pair with that supply code.

You can find a table of COVID-19 vaccine codes, including vaccine names and dosing intervals, in CPT® Appendix Q: Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2) (corona virus disease [COVID-19]) Vaccines. The AMA updates this appendix as changes occur. Fees for the new codes can be found on the Centers for Medicare & Medicaid Services’ COVID-19 vaccines and monoclonal antibodies page.

To help you understand the intent of new codes 0081A, 0082A, and 91308, the AMA also posted a CPT® Assistant Special Edition: February Update on its COVID-19 CPT® vaccine and immunization codes page. The AMA did not post third-dose admin code 0083A until June 7, 2022, so that is why it is not included in the February CPT® Assistant Special Edition that provides guidance on the other related codes

 

For More Information: https://www.aapc.com/blog/83991-covid-19-vaccine-codes-for-patients-4-years-and-younger/