MEC Practice Academy 11.19
|Articles|August 3, 2021

AMA releases provisional CPT code for third dose of Pfizer COVID-19 vaccine

As additional vaccinations may become necessary this code will ensure physicians can get paid.

The American Medical Association (AMA) has announced an update to the current CPT code set to include a designation for additional COVID-19 vaccine doses.

According to a news release, a new provisional code will be effective for use should a third dose of the Pfizer COVID-19 vaccine receive regulatory approval or authorization from the Food and Drug Administration (FDA).

“The FDA and the U.S. Centers for Disease Control and Prevention (CDC) have analyzed data indicating that at this time individuals do not need to exceed the standard two doses authorized for Pfizer’s COVID-19 vaccine,” AMA President Gerald Harmon, MD, says in the release. “The AMA supports the position of the CDC and FDA since it is based on a careful consideration of the available evidence to date. We are confident that federal health agencies will continue to review emerging evidence on a potential third dose of the Pfizer COVID-19 vaccine. The CPT code set stands ready to meet the immediate needs of the health system if third dose shots are considered necessary.”

The new vaccine administration CPT code and long descriptor, as it appears in the release, is:

0003AImmunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; third dose

Last week, researchers from Pfizer released a study which found that the company’s two-dose vaccine produced a 96 percent efficacy rate against symptomatic COVID-19 two months after the second shot, but the protection fell every two months after that coming to about 83.7 percent efficacy after four to six months.

Earlier in July, the company announced that a third dose of the vaccine given six months after the second dose has a consistent tolerability profile and elicits high neutralization titers five or 10 times higher than the primary doses.

President Joe R. Biden’s administration, though, is still resistant to recommending booster shots. A joint statement from the CDC and FDA denied the need for the additional vaccinations.

“Americans who have been fully vaccinated do not need a booster shot at this time. FDA, CDC, and NIH are engaged in a science-based, rigorous process to consider whether or when a booster might be necessary,” the statement says. “This process takes into account laboratory data, clinical trial data, and cohort data – which can include data from specific pharmaceutical companies, but does not rely on those data exclusively. We continue to review any new data as it becomes available and will keep the public informed. We are prepared for booster doses if and when the science demonstrates that they are needed.”


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