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CPT Codes for Third Doses of COVID-19 Vaccine

The American Medical Association (AMA) on 16th August 2021 announced that the Current Procedural Terminology (CPT®) code set is ready for the rollout of third doses of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has expedited approval of a new administration code that is unique to a third dose of the current COVID-19 vaccine from Moderna. A new administration code for a third dose of the current COVID-19 vaccine from Pfizer was announced by the AMA on July 30. The two vaccine administration codes are effective for immediate use as the U.S. Food and Drug Administration (FDA) has authorized third doses of COVID-19 vaccines from Pfizer and Moderna for certain people with weakened immune systems. AMA President Gerald Harmon, M.D. said in a statement, “CDC data shows some immunocompromised patients lack the antibodies needed to fight COVID-19 infection, adding an additional dose to the primary series for this population can help protect these individuals from unnecessary hospitalizations and deaths. It is important to keep in mind that this recommendation is for a limited population and an additional dose of COVID-19 vaccine is not recommended for all fully vaccinated people at this time.” For quick reference, the CPT codes and long descriptors assigned to third dose administration of the current Pfizer and Moderna COVID-19 vaccines are:

Pfizer

0003A: 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; the third dose

Moderna

0013A: 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, 100 mcg/0.5 mL dosage; the third dose

These CPT codes and descriptors are used to report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record. These codes are only to be used for third doses for immunocompromised individuals, which are different than booster shots. While the Biden Administration has announced its intent to offer booster shots to the general population, there is not currently a formal recommendation or Food and Drug Administration approval for them. The AMA will update its coding guidance if a booster schedule is approved.

We are sharing CPT codes for the first and second doses of Pfizer and Moderna for reference purposes. Detailed guidance on COVID-19 coding can be found on the AMA website

First and Second Dose for Pfizer

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/0.3mL dosages, diluent reconstituted; first dose. (The 0001A COVID-19 vaccine administration CPT code is for the first dose of the Pfizer vaccine only.)

0002A: 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/0.3mL dosages, diluent reconstituted; second dose. (The 0002A COVID-19 vaccine administration CPT code is for the second dose of the Pfizer vaccine only.)

First and Second Dose for Moderna

0011A: 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, 100 mcg/0.5mL dosages; first dose. (The 0011A COVID-19 vaccine administration CPT code is for the first dose of the Moderna vaccine only.)

0012A: 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, 100 mcg/0.5mL dosages; second dose. (The 0012A COVID-19 vaccine administration CPT code is for the second dose of the Moderna vaccine only.)

If you need any assistance in medical coding for COVID-19 vaccinations, contact us for more information. MedicalBillersandCoders (MBC) is a leading provider of medical billing and coding services. Our expertise in various medical billing specialties ensures quick and accurate insurance reimbursements. To know more about our medical billing and coding services, contact us at info@medicalbillersandcoders.com/ 888-357-3226

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