On 19th Jan 2020, the American Medical Association (AMA) added new CPT codes (91302 and 0031A) for Janssen COVID-19 Vaccine, a division of Johnson & Johnson. Janssen is a single-dose COVID-19 vaccine which is 4th vaccine to get unique CPT codes for documentation and billing. The new CPT codes will be effective for use on the condition that the Janssen COVID-19 vaccine receives approval or emergency use authorization from the Food and Drug Administration (FDA). The AMA is publishing the new CPT codes now to ensure electronic systems across the U.S. health care system are updated and prepared for the prospect of FDA approval or authorization for the Janssen COVID-19 vaccine.
An FDA approval for Janssen’s COVID-19 vaccine is still ‘weeks away,’ but according to Johnson & Johnson, the single-dose vaccine candidate is generating positive results. Johnson & Johnson released data from an interim Phase 1/2a clinical trial late last week showing that the investigational COVID-19 vaccine candidate (JNJ-78436735) provided an immune response for at least 71 days. JNJ-78436735 was also well-tolerated across all study participants, the data revealed.
As per AMA President Susan R. Bailey, “Janssen’s single-dose COVID-19 vaccine would mark a big change from the double-dose vaccines currently available. The change will place greater importance on accurately reporting COVID-19 immunizations by vaccine type and dose to ensure patients complete the appropriate immunization schedule. Unique CPT codes that clinically distinguish each COVID-19 vaccine provide the needed informational precision to ensure optimal vaccine distribution and administration.”
CPT Codes for Janssen COVID-19 Vaccine
For quick reference, the Janssen COVID-19 vaccine has been assigned the following Category I CPT code and long descriptor:
- CPT Code 91303: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative-free, 5×1010 viral particles/0.5mL dosage, for intramuscular use.
In addition to the new vaccine-specific product CPT code, the Janssen COVID-19 vaccine has been issued a vaccine administration CPT code that is specific to its one-dose immunization schedule. This CPT code is 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.
- 0031A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative-free, 5×1010 viral particles/0.5mL dosage, single dose.
CPT Codes for COVID-19 Vaccine
Janssen’s COVID-19 vaccine is the fourth vaccine candidate to get its own CPT code from AMA, following the candidates from Pfizer, Moderna, and AstraZeneca. These unique CPT codes are created to clinically distinguish each vaccine and immunization administration for better tracking, reporting, and analysis that supports data-driven planning and allocation. The new COVID-19 vaccine coder resource will be updated to include the new CPT codes created for the Janssen COVID-19 vaccine.
Pfizer’s Vaccine Codes
- CPT 91300: 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, for intramuscular use.
- CPT 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.
- CPT 0002A: second dose.
Moderna’s Vaccine Codes
- CPT 91301: 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, for intramuscular use.
- 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.
- 0012A: second dose.
AstraZeneca’s Vaccine Codes
- CPT 91302: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative-free, 5×1010 viral particles/0.5mL dosage, for intramuscular use.
- CPT 0021A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative-free, 5×1010 viral particles/0.5mL dosage; first dose.
- CPT 0022A: second dose.
Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine augmented intelligence and other aspects of a modern health care system. This process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
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Reference:
AMA announces vaccine-specific CPT codes for coronavirus immunizations
