COVID-19 Coding Update

The American Medical Association (AMA) today announced that the Current Procedural Terminology (CPT®code set is being updated by the CPT Editorial Panel to include vaccine and administration codes that are unique to the COVID-19 vaccine candidate under development by Janssen Pharmaceutica, a division of Johnson & Johnson.

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.

“Janssen’s single-dose COVID-19 vaccine would mark a big change from the double-dose vaccines currently available,” said AMA President Susan R. Bailey, M.D. “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.”

The Janssen COVID-19 vaccine joins other COVID-19 vaccines from Pfizer, Moderna and AstraZeneca that were previously issued unique CPT codes to clinically distinguish each vaccine and immunization administration for better tracking, reporting and analysis that supports data-driven planning and allocation. To help ensure accurate coding and reporting of COVID-19 vaccines and immunization services, the AMA offers a new resource to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine provided to each patient. The new COVID-19 vaccine coder resource will be updated to include the new CPT codes created for the Janssen COVID-19 vaccine.

For quick reference, the Janssen COVID-19 vaccine has been assigned the following Category I CPT code and long descriptor:

91303Severe 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.

For quick reference, the Janssen COVID-19 vaccine has been assigned the following vaccine administration CPT code and long descriptor:

0031AImmunization 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

Short, medium and long descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.

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 rigorous editorial 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.

For More Information: https://www.ama-assn.org/press-center/press-releases/ama-announces-update-covid-19-vaccine-cpt-codes

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