AMA publishes new codes for updated COVID-19 vaccines, boosters

There are eight new codes to represent the COVID-19 updated booster shots announced Aug. 31 by the U.S. Food and Drug Administration (FDA).

The American Medical Association (AMA) announced the editorial update to Current Procedural Terminology. The updated bivalent vaccine boosters, made by Moderna and BioNTech, have mRNA for the original virus strain and the BA.4 and BA.5 omicron variants, in a single dose.

“Across the nation, 108 million Americans – or more than half of those eligible to be boosted – have yet to receive their first booster dose despite evidence that they are safe and highly effective against severe disease outcomes,” AMA President Jack Resneck Jr., MD, said in the AMA announcement.

The U.S. Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP) is scheduled to meet starting Sept. 1 to review the updated boosters. AMA looks forward to the analysis and pending recommendations, Resneck said.

“As we prepare for potential fall and winter surges of COVID-19, the AMA encourages all who are eligible to get a booster and review the available options with a physician," he said in the AMA announcement.

Effective immediately

The AMA announcement stated: “CPT codes distinguish the type and dose of a COVID-19 vaccine and booster provided to each patient and allows for data-driven reporting and analysis that supports effective monitoring of vaccine administration, vaccine safety, as well as other critical aspects of the public health response to the COVID-19 pandemic.”

Four of the codes are effective for use immediately. They are:

Moderna bivalent booster for patients aged 18 years and older

• 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.
• Code 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.

Pfizer-BioNTech bivalent booster for patients aged 12 years and older.

• Code 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.
• Code 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.

Pending approval for youths

Four CPT codes will be effective for use on the condition that the FDA authorizes Moderna’s new COVID-19 booster in patients aged 6 through 11 years of age and Pfizer-BioNTech’s new COVID-19 booster in individuals 5 years through 11 years of age.

Moderna bivalent booster – 6 through 11 years

• 91314: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use.
• 0144A: 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, 25 mcg/0.25 mL dosage, booster dose.

Pfizer-BioNTech bivalent booster – aged 5 through 11 years

• 91315: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use.
• 0154A: 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, booster dose.