Pediatric Coding Alert

Question: I know we now have CPT^® vaccine and vaccine administration codes for the current Pfizer and Moderna COVID-19 immunizations, and that we also have them for the forthcoming AstraZeneca vaccine pending Federal Drug Administration (FDA) approval. But are there any more COVID-19 vaccine codes we should know about?

New York Subscriber

Answer: Yes. On Jan. 19, 2021, the American Medical Association (AMA) released a fourth COVID-19 vaccine code — 91303 (Severe acute respiratory syndrome coronavirus 2 (SARSCoV-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) — for drug manufacturer Janssen’s COVID-19 vaccine.

Like the AstraZeneca vaccine, however, this vaccine is still awaiting FDA emergency use authorization, so you will not be able to use it until the vaccine gets FDA approval and Medicare claims processing systems accept it.

Like the other three vaccines, you will also have a new administration code to go with 91303, which is 0031A (Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-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). Unlike the other vaccines, however, the Janssen vaccine has a single-dose schedule, so there is no CPT^® code for a second administration.

Further information: To know when FDA will authorize the emergency use of the AstraZeneca and Janssen COVID-19 vaccines, and when the new CPT^® codes will become valid, monitor the FDA’s COVID-19 vaccine page at www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.