On 19th May 2022, the American Medical Association (AMA) announced an update to Current Procedural Terminology (CPT®) including new product and administration codes assigned to the Moderna COVID-19 vaccine for children 6 months through 5 years old. While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a CPT code to ensure healthcare professionals are prepared for the shot’s potential use.
The provisional CPT codes are effective for use on the condition that Moderna’s pediatric COVID-19 vaccine candidate is granted an Emergency Use Authorization by the U.S. Food and Drug Administration (FDA). The AMA is publishing the CPT code update now to ensure electronic systems across the U.S. health care system are prepared in advance for the potential FDA authorization.
CPT codes clinically distinguish each coronavirus vaccine and dosing schedule to allow for data-driven tracking, reporting, and analysis that supports planning and allocation during the public health response to the pandemic. To date, 38 CPT codes have been created for reporting COVID-19 vaccines.
CPT codes help healthcare providers track, report, and analyze vaccine data by distinguishing between the different vaccine types and dosing schedules. Healthcare professionals also use this data to plan and allocate vaccine distribution.
To help ensure accurate coding and reporting of COVID-19 vaccines and immunization services, you can also refer to AMA’s coding resource ‘find COVID-19 Vaccine Code’ to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine provided to each patient.
Moderna COVID-19 Vaccine Codes for Children
The new product code and administration codes assigned to the Moderna COVID-19 vaccine for children in the age range of 6 months to 5 years are:
Product Code
- CPT 91311: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 25 mcg/0.25 mL dosage, for intramuscular use
Administration codes
- CPT 0111A: 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, 25 mcg/0.25 mL dosage; first dose
- CPT 0112A: 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, 25 mcg/0.25 mL dosage; second dose
At the end of April 2022, AMA released a provisional CPT code for Pfizer’s COVID-19 booster for children between 5 and 11 years old, which had not received FDA authorization at the time. Since then, the FDA has granted emergency use authorization for the shot.
In February 2022, AMA also created provisional CPT codes for Pfizer’s COVID-19 vaccine for children between six months and five years, though it has yet to receive FDA authorization.
We shared these newly added Moderna COVID-19 vaccine codes just for reference only. You can refer to the following AMA link for detailed information about COVID-19 vaccine codes. Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services.
Our expert medical coders are well-versed with billing guidelines and coding updates. We can assist you in receiving accurate insurance reimbursements from private and government payers. To know more about our medical specialty-wise billing services, contact us at info@medicalbillersandcoders.com/ 888-357-3226
CPT © Copyright 2022 American Medical Association. All rights reserved. AMA and CPT have registered trademarks of the American Medical Association.
Reference: AMA announces CPT update for pediatric COVID-19 vaccine candidate
FAQs
1. What is the new CPT code for the Moderna COVID-19 vaccine for children?
The new product code is CPT 91311, and the administration codes are CPT 0111A for the first dose and CPT 0112A for the second dose for children aged 6 months to 5 years.
2. Are these CPT codes already in use?
These codes are provisional and can be used only if the FDA grants Emergency Use Authorization for the Moderna COVID-19 vaccine for children in this age group.
3. Why are CPT codes important for COVID-19 vaccines?
CPT codes help track, report, and allocate vaccine distribution and ensure accurate billing for the different types and doses of COVID-19 vaccines.
4. How does AMA help with COVID-19 vaccine coding?
The AMA provides resources, including the ‘find COVID-19 Vaccine Code’ tool, to help healthcare professionals identify the correct CPT codes for each vaccine type and dose.
5. Can Medical Billers and Coders assist with these new CPT codes?
Yes, Medical Billers and Coders (MBC) is experienced in using the latest CPT codes and can help healthcare providers with billing and accurate reimbursements from insurers.
