Updated Booster Codes for COVID-19 Vaccine Released

Updated Booster Codes for COVID-19 Vaccine Released

Age determines who qualifies for the bivalent formulations from Pfizer and Moderna.

On Aug. 31, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) of the Moderna and Pfizer-BioNTech COVID-19 vaccines to include updated booster bivalent formulations. These latest formulations include messenger RNA components to help build immunity against both the original SARS-CoV-2 strain and two lineages of the omicron variant.

Four new CPT® administration codes and four new CPT® supply codes were created for reporting the bivalent vaccines, but not all of the codes are covered by the updated EUAs. Here are the details.

How to Code the Pfizer Updated Boosters

Although the CPT® code descriptors don’t state ages or manufacturers, the vaccines they represent are aimed at specific age groups and made by specific companies.

The new codes for the Pfizer-BioNTech updated boosters are:

Pfizer Bivalent VaccinesSupply CodeBooster Admin Code
12 Years and Older913120124A
5 to 11 Years913150154A

Both the supply and admin codes specify “bivalent,” but only the admin codes specify “booster.” Here is an example:

91312   Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use

0124A   Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, booster dose

EUA: The FDA states, “the Pfizer-BioNTech COVID-19 Vaccine, Bivalent, is authorized for use as a single booster dose in individuals 12 years of age and older.” The relevant codes are 91312 and 0124A. The revised EUA does not include the updated booster for 5- to 11-year-olds (91315, 0154A).

How to Code the Moderna Updated Boosters

The new Moderna bivalent COVID-19 vaccine codes were released at the same time as the Pfizer codes. The codes for the Moderna updated boosters are:

Moderna Bivalent VaccinesSupply CodeBooster Admin Code
18 Years and Older913130134A
6 to 11 Years913140144A

The code descriptors for the Moderna booster codes also include “bivalent” in both the supply and admin codes and “booster” in the admin code:

91313    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use

0134A   Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, booster dose

EUA: At this time, “The Moderna COVID-19 Vaccine, Bivalent, is authorized for use as a single booster dose in individuals 18 years of age and older,” the FDA states. You’ll use 91313 and 0134A to report those boosters. The revised EUA does not include the updated booster for 6- to 11-year-olds (91314, 0144A).

When in Doubt, Reference Appendix Q

The similarities among COVID-19 vaccine code descriptors can make it hard to find the right code. While checking the dosage listed in each code descriptor can help you select the correct option, your best bet is to start with a tool like the CPT® Appendix Q, which matches codes to vaccine names, national drug codes, and more.  

See also AAPC’s Coding COVID-10 Vaccination tool.

Deborah Marsh

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