We all are aware of the currently available COVID-19 vaccines from AstraZeneca, Janssen (Johnson & Johnson), Moderna and Pfizer and their unique CPT® codes. These medical codes allow for each vaccine and immunization administration to be clinically distinct, allows for better tracking, reporting and analysis (i.e., utilization data). The American Medical Association has released new COVID-19 vaccine codes for the Novavax vaccine in front of the FDA approval.

Note: These CPT codes are provisional and will be effective for use on the condition that the Novavax COVID-19 vaccine receives the Food and Drug Administration (FDA) approval or emergency use authorization. The Category I CPT code and long descriptor for Novavax vaccine is:

91304       Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage, for intramuscular use

AMA CPT has also assigned the following Novavax COVID-19 vaccine administration codes and long descriptors:

0041A    Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage; first dose

0042A    Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage; second dose

Advance notice of these codes allows for computer systems to be updated appropriately, this would include the “Charge Description Master” or CDM file(s). You can access the 5/4/2021 AMA CPT code announcement at: AMA announces update to COVID-19 vaccine CPT codes | American Medical Association (ama-assn.org)

In addition, you can access other AMA CPT information regarding COVID-19 at: COVID-19 CPT coding and guidance | American Medical Association (ama-assn.org)

Health Information Management (HIM) Coding professionals need to keep up to date with information and guidance on medical codes and with the COVID-19 Public Health Emergency (PHE) related information. Reach out to your external consultants for auditing services, education and more information about the coding of COVID-19, with both ICD-10-CM/PCS and CPT.

Written by Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer

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