AMA Updates CPT Codes for COVID-19 Vaccines, Boosters

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The 2022 update to the Current Procedural Terminology (CPT) codes from the American Medical Association (AMA) incorporates a series of 15 vaccine-specific codes, including boosters.

These codes represent “the model for efficiently reporting and tracking immunizations and administrative services” against the SARS-CoV-2 virus, the AMA said in a September 7 news release.

The AMA has worked closely with officials at the US Centers for Disease Control and Prevention to develop vaccine-specific CPT codes.

The AMA introduced the first codes in the series for use in November 2020 to distinguish each COVID-19 vaccine and dosing schedule for better tracking, reporting, and analysis of patient vaccinations, as reported by Medscape Medical News.

These CPT codes were published before COVID-19 vaccines were available so that they could be incorporated into healthcare electronic systems across the United States.

“Data-driven planning and resource allocation is vital for effective immunization programs that will bring the coronavirus pandemic to an end,” AMA President Gerald E. Harmon, MD, said in the news release.

“Correlating each coronavirus vaccine and dosing schedule with its own unique CPT code has provided necessary analytical advantages to help track, allocate and optimize resources for immunization programs across the United States,” he said.

Provisional Code for Third Pfizer Dose

In July, the AMA announced creation of a provisional CPT code unique to a potential third dose of the Pfizer COVID-19 vaccine. “The provisional CPT code will be effective for use on the condition that a third dose shot of the Pfizer COVID-19 vaccine receives regulatory approval or authorization from the US Food and Drug Administration (FDA),” the AMA said in a July 30 news release. “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,” Harmon said in the release.

To help ensure accurate coding and reporting of COVID-19 vaccines and administration services, the AMA has published a vaccine code finder resource to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine given to each patient.

The 2022 CPT code set also includes an appendix for one-stop access to all the codes for COVID-19 vaccine reporting. The COVID-19 vaccine and administration codes are among 405 editorial changes in the 2022 CPT code set, including 249 new codes, 63 deletions, and 93 revisions.

“The CPT code set continues to see growth in new and novel areas of medicine with 43% of editorial changes tied to new technology services described in Category III CPT codes and the continued expansion of the Proprietary Laboratory Analyses (PLA) section of the CPT code set,” the AMA said.

The AMA will host two virtual events in November ― the Outpatient CDI Workshop and the CPT and RBRVS 2022 Annual Symposium ― to help the healthcare community stay up to date on the significant CPT code changes for 2022.

Meeting agendas and registration are available on the AMA website.

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