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COVID-19 Vaccines

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-03-10

To accommodate the new COVID-19 immunizations the CPT editorial panel has approved 11 Category I codes. Watch for new and revised guidelines and parenthetical notes with these codes. For example; which administration codes should be used with the vaccine codes and the NCD codes applicable to the dose being administered. These codes will be effective through the duration of the Public Health Emergency. These codes were granted approval from the FDA on 12/11/20 and first appeared in the CPT codeset on 01/01/2021. 

4 New Vaccine Codes:

91300, 91301, 91302, 91303

7 New Administration codes to be used with the Vaccine codes:

0001A, 0002A, 0011A, 0012A, 0021A, 0022A, 0031A 

Additional codes for Novavax will be available for use and effective when that particular coronavirus vaccine gets emergency use authorization or approval from the FDA.

91304 with administration codes 0041A and 0042A.

Vaccine Code

Description

Admin Code

MFG NDC 10/NDC 11 Prod ID (vial) Dosing
91300

SARS-CoV-2

30 mcg/0.3mL dosage

Dose #1 0001A

Dose #2  0002A 

Pfizer, Inc

Dose #1 59267-1000-1

Dose #2 59267-1000-01

21 Days
91301

SARS-CoV-2

100 mcg/0.5mL dosage

Dose #1 0011A

Dose #2 0012A

Moderna, Inc

Dose #1 80777-273-10

Dose #2 80777-0273-10

28 Days
91302

SARS-CoV-2

5x1010 viral particles/0.5mL dosage

Dose #1 0021A

Dose #2 0022A

AstraZeneca, Plc

Dose #1 0310-1222-10

Dose #2 00310-1222-10

28 Days
91303

SARS-CoV-2

 5x1010. viral particles/0.5mL dosage

1 Dose 0031A Janssen 59676-580-05 59676-0580-05 N/A
91304

SARS-CoV-2

Subunit Prot Vac-Novavax IM 5 MCG/0.5ML

Dose #1 0041A

Dose #2 0042A

Novavax

Dose # 1  80631-100-01

Dose #2 80631-1000-01

21 Days

The crosswalks are intended to help entities and providers who bill for drugs understand which drug products that are identified by NDCs are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States but are current to the best of our knowledge as of the writing of the article.

NOTE: Code list updated 05/13/2020, at the time of this update the Novavax codes were released by the AMA, however, the drug is pending approval from the FDA and will be effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration.

5/13/2021 added new codes to table 91304, 0041A, 0042A. CW

References