WADA announces update of COVID-19 vaccine CPT codes

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CHICAGO – The American Medical Association (AMA) today announced that Current Procedural Terminology (CPT®) has been updated by the CPT’s Editorial Board to include vaccine and administration codes that are unique to a new formulation of the COVID-19 vaccine developed by Pfizer. The new formulation is based on a tris-sucrose buffer rather than the phosphate buffer present in the original formulation.

The interim CPT codes will be effective provided that Pfizer’s tris-sucrose formulation of the COVID-19 vaccine receives approval or emergency use clearance from the United States Food and Drug Administration (FDA). WADA Now Issuing Updated CPT Code To Ensure US Healthcare Electronic Systems Are Prepared In Advance For FDA Approval Or Potential Clearance Of The Tris-Sucrose Formulation Of The COVID Vaccine -19 from Pfizer.

The development of vaccine-specific CPT codes has clinically distinguished each coronavirus vaccine and dosing schedule for better tracking, reporting, and analysis that supports data-driven planning and allocation. The COVID-19 vaccines from AstraZeneca, Janssen (Johnson & Johnson), Moderna, Novavax and the original formulation from Pfizer have already received unique CPT codes.

To help ensure accurate coding and reporting of COVID-19 vaccines and immunization services, WADA offers a vaccine code search resource to help identify the appropriate combination of CPT codes for the type and dose of COVID-19 vaccine provided to each patient.

For quick reference, the new vaccine and administration codes assigned to the tris-sucrose formulation of Pfizer’s COVID-19 vaccine are:

Pfizer vaccine code (tris-sucrose formulation)

91305 Coronavirus 2 Severe Acute Respiratory Syndrome (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, peak protein, preservative-free, strength 30 mcg / 0.3 mL, tris-sucrose formulation, for intramuscular use

Pfizer administration codes (tris-sucrose formulation)

0051A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, no preservative, dose of 30 mcg / 0.3 mL, tris-sucrose formulation; first dose

0052A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, no preservative, dose of 30 mcg / 0.3 mL, tris-sucrose formulation; second dose

0053A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, no preservative, dose of 30 mcg / 0.3 mL, tris-sucrose formulation; third dose

In addition to the new vaccine-specific CPT codes, the CPT’s editorial board approved provisional CPT codes for COVID-19 vaccine booster doses created by Moderna and Pfizer. While the Pfizer booster will likely remain at the same dose as the existing formulation, the Moderna booster will likely be given at a different dose than the existing formulation. For this reason, a new vaccine code has been created for the Moderna booster vaccine. These interim CPT codes will be effective for use provided that the booster doses of the COVID-19 vaccines created by Moderna and Pfizer receive FDA approval or clearance.

For quick reference, the new vaccine and administration codes assigned to the tris-sucrose formulation of Pfizer’s COVID-19 vaccine are:

Moderna callback code

91306 Coronavirus 2 Severe Acute Respiratory Syndrome (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 50 mcg / 0.25 mL dose, for intramuscular use

Moderna booster administration code

0064A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 50 mcg / 0.25 mL dose, booster dose

Administration codes for Pfizer boosters (original formulation and tris-sucrose)

0004A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, no preservative, strength 30 mcg / 0.3 mL, reconstituted diluent; booster dose

0054A Administration of vaccination by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, no preservative, dose of 30 mcg / 0.3 mL, tris-sucrose formulation; booster dose

Short, medium and long descriptors for all new vaccine-specific CPT codes are available on the WADA website, along with other recent changes to the CPT code set that have helped streamline the response from public health to SARS-CoV-2 virus and COVID-19 disease.

Changes to the CPT code set are taken into account as part of an open editorial process managed by the CPT Editorial Board which garners broad input from the healthcare community and beyond to ensure that the CPT content reflects the coding requirements of digital health, precision medicine, augmented intelligence, and other aspects of a modern healthcare system. This rigorous editorial process keeps the CPT code up to date with contemporary medical science and technology so that it can fulfill its vital role as the trusted language of medicine today and code for its future.

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Questions about the coding and content of the CPT should be directed to CPT network, the authoritative source for CPT coding responses. Also check out AMA’s online COVID-19 CPT Coding and Advice library.


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