The American Medical Association (AMA) (@AmerMedicalAssn) announced that the Current Procedural Terminology (CPT®) code set has been updated by the CPT Editorial Panel to include vaccine and administration codes for pediatric doses of the COVID-19 vaccine developed by Pfizer.
The provisional CPT codes will be effective for use on the condition that Pfizer’s two-dose regimen for the prevention of COVID-19 in children ages 5 to 11 receives approval or emergency use authorization from the U.S. Food and Drug Administration (FDA). The AMA is publishing the CPT code update now to ensure electronic systems across the U.S. health care system are prepared in advance for the potential FDA approval or authorization.
“The AMA supports the goal of extending COVID-19 immunization protection to a broader age range of children,” said AMA President Gerald E. Harmon, M.D. “A rigorous, transparent review process by the Federal Drug Administration and Centers for Disease Control and Prevention will examine the safety and efficacy of Pfizer’s COVID-19 vaccine for potential use in children between ages 5 and 11. An open and comprehensive evaluation of data from pediatric vaccine trials is critical to inspire necessary public confidence in COVID-19 vaccines for children under age 12.”
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. COVID-19 vaccines from AstraZeneca, Janssen (Johnson & Johnson), Moderna, Novavax and Pfizer have previously been issued unique CPT codes.
To help ensure accurate coding and reporting of COVID-19 vaccines and immunization services, the AMA offers a vaccine code finder resource to help identify the appropriate CPT code combination 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 pediatric doses of Pfizer’s COVID-19 vaccine are:
Vaccine product code
- 91307 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use
Vaccine Administration Codes
- 0071A – Immunization 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose
- 0072A – Immunization 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose
Short, medium and long descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with other recent modifications to the CPT code set that have helped streamline the public health response to the SARS-CoV-2 virus and the COVID-19 disease.
Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
Questions on CPT coding and content should be directed to the CPT Network, the authoritative source for CPT coding answers. Also consult the AMA online library of COVID-19 CPT coding and guidance.
About the American Medical Association
The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.