AMA Releases COVID-19 Vaccine Code for Janssen
A fourth COVID-19 vaccine code has been released by the American Medical Association’s CPT® Editorial Panel, along with a proprietary administration code.
The AMA released on Jan. 19, 2021, 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.
However, like the code for AstraZeneca, this vaccine code will not become effective until the Food and Drug Administration issues the vaccine product Emergency Use Authorization or approval. And Medicare claims processing systems will not accept 91303 until that happens.
When and if the FDA issues the Janssen COVID-19 vaccine EUA/approval, providers will report 91303 with new administration CPT® code 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.
Note that Janssen is a single dose vaccine, requiring a single administration. Providers will not have any reason to report 0031A more than once for a patient in any given year. In a Special Edition: January Update of CPT® Assistant, the AMA provides coding guidance for these new additions to the CPT® vaccine and administration code collection.
The AMA has also released an update to Appendix Q in CPT®, which includes the vaccine’s National Drug Code: NDC 10/11 labeler product ID 59676-580-05/59676-0580-05.
5 New Medicine Codes for July 1
The CPT® Editorial Panel also released early an additional five new codes in the Medicine/Vaccine, Toxoids section of the AMA’s CPT®. The following codes are effective July, 1, 2021, but won’t be published until CPT® 2022:
90626 Tick-borne encephalitis virus vaccine, inactivated; 0.25 mL dosage, for intramuscular use
90627 Tick-borne encephalitis virus vaccine, inactivated; 0.5 mL dosage, for intramuscular use
90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use
90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use
90758 Zaire ebolavirus vaccine, live, for intramuscular use
These codes will be listed out of sequence. Medicare coverage will be determined by the Centers for Medicare & Medicaid Services in future rulemaking.