0011a cpt code

CPT codes, or current procedural terminology codes, are codes assigned to describe all healthcare services, including medical, surgical, and diagnostic services. These codes allow billing standardization according to the service provided and service tracking for data analysis and performance management.

CPT codes are of different categories:

  • Category I codes describe the healthcare service provided and the procedure or treatment healthcare workers administer in inpatient or outpatient settings.
  • Category II codes are used for service tracking and performance management. 

Following the coronavirus outbreak in March 2020 and the swift progress made in research fields, the world watched in anticipation as world-class research think tanks raced to create a vaccine for the viral pandemic. Fast forward to today, and the United States currently has five vaccine products approved by the American Medical Association (AMA) and the Food and Drug Administration. 

AMA has published a comprehensive list of 28 Category I CPT codes for healthcare providers administering the COVID-19 vaccine. In close association with the Centers for Disease Control and Prevention, the CPT Editorial Panel has created unique codes for each vaccine product (including Pfizer BioNTech, Moderna, AstraZeneca/University of Oxford, Novovax, and Janssen) and the specific dosage being administered. The codes are used to report the five vaccine products, including third doses and booster shots. 

These CPT codes were published before vaccines were available to the public to facilitate timely updating in electronic health records across the country. They are effective immediately, owing to the Emergency Use Authorization approval from the Food and Drug Association. 

The COVID vaccine codes are grouped as follows:

  • Vaccine code – specifying the vaccine product, such as 91301 for the Moderna COVID-19 Vaccine. 
  • Administration code – specifying which dose in the regimen is being administered, such as 0011A for Moderna COVID-19 Vaccine, first dose. 

Each Category I CPT Code is also followed by a long descriptor for the vaccine product, which you can access at the AMA website. 

The section below provides all the relevant information regarding the newly added Covid vaccine CPT codes. 

cpt 0002a

Covid-19 Vaccine CPT Codes

Pfizer

Vaccine name: Pfizer-BioNTech Covid-19 Vaccine

Vaccine code: 91300

Administration code: 0001A (first dose), 0002A (second dose), 0003A (third dose), 0004A (booster).

Description: 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.

Vaccine name: Pfizer-BioNTech Covid-19 Vaccine

Vaccine code: 91305

Administration code: 0051A (first dose), 0052A (second dose), 0053A (third dose), 0054A (booster). 

Description: 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, tris-sucrose formulation.

Vaccine name: Pfizer-BioNTech Covid-19 Vaccine

Vaccine code: 91307

Administration Code: 0071A (first dose), 0072A (second dose),

Description: 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, 10mcg/0.2mL dosage, diluent reconstituted, tris-sucrose formulation.

As you can see above, codes for Pfizer vary according to the formulation and concentration of the vaccine. (Underlined for clarity.)

 

Moderna

Vaccine name: Moderna COVID-19 Vaccine

Vaccine code: 91301

Administration code: 0011A (first dose), 0012A (second dose), 0013A (third dose). 

Description: 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.

Vaccine name: Moderna COVID-19 Vaccine

Vaccine code: 91306

Administration Code: 0064A (Booster)

Description: 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/0.25mL dosages.

 

AstraZeneca

Vaccine name: AstraZeneca COVID-19 Vaccine

Vaccine code: 91302

Administration Code: 0021A (first dose), 0022A (second dose)

Description: 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, 5×10¹º viral particles/0.5mL dosage. 

cpt 0012a

Janssen

Vaccine name: Janssen COVID-19 Vaccine

Vaccine code: 91303

Administration Code: 0031A (single dose), 0034A (Booster).

Description: 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, 5×10¹º viral particles/0.5mL dosage. 

 

Novovax

Vaccine name: Novovax COVID-19 Vaccine

Vaccine code: 91304

Administration code: 0041A (first dose), 0042A (second dose). 

Description: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative-free, 5mcg/0.5mL dosage.

Coding for Vaccine Administration at Home

In addition to the codes mentioned above for each specific vaccine product and dose, the healthcare provider will use the HCPCS Level II code M0201 to account for the additional payment. The HCPCS code will consider additional services provided by the healthcare worker to provide the facility of vaccinating the patient at home. 

However, it may only be used once per home per date of administration. For example, a healthcare worker may vaccinate three individuals inside the same house. The HCPCS Level II billing code will only be used once per administration date instead of thrice separately for each individual on the same date. 

Examples of Vaccine Coding 

If a medical coder wants to code for the first dose of the Moderna vaccine, they will use the following codes:

  • Vaccine CPT Code: 91301
  • Administration Code: 0011A
  • ICD-10: Z23
  • NDC: 80777-0273-10

For the second dose, they will use all the same codes with one exception. The administration code they use this time will be 0012A. 

Similarly, if they want to code for the Pfizer vaccine, they will use the following codes: 

  • Vaccine CPT Code: 91300
  • Administration Code: 0001A
  • ICD-10: Z23
  • NDC: 59267-1000-01

For the second dose, they will change the administration code to 0002A. 

Importance of CPT codes 

The new CPT codes distinguish each coronavirus vaccine from the other to establish a substantial layout that can track the administration of the vaccine to the public. Tracking, reporting, and analysis are significant in the research process for better access to vaccines for all strata and further facilitate planning and allocation of vaccination. 

Codes for the third dose account for the actual administration of the dosage and the counseling provided to patients, and the work of manually uploading the codes to EHRTakeaway

In retrospect, the coronavirus pandemic rocked the stable healthcare boat quite hard. After innumerable trials and failures, vaccines were a breakthrough in such trying times. Vaccines were the new dawn of hope and a means to achieve ‘normalcy.’ 

It is commendable how swiftly the healthcare industry publicly facilitated the release of vaccines while simultaneously laying down a highly effective plan for data collection and dosage tracking to prevent any health discrepancies. This data is invaluable for performance improvement, as mentioned previously. 

See Also: ICD-10 Codes – Correctly Coding Type 1 Diabetes Mellitus

So, on our way to the new normal, it is not only important to get vaccinated. Rather, medical coders need to know how to code for the administered vaccines accurately and add the correct information to the data pool.  You may visit the AMA website for recent CPT modifications, code tracking, vaccine descriptors, and more.

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