On Oct. 10, 2022, the American Medical Association (AMA) released a new code for administration of the Novavax COVID-19 booster. On Oct. 12, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) for the bivalent Moderna and Pfizer-BioNTech vaccines to be used in younger age groups.
Novavax Booster Code 0044A
The AMA published a new code that you’ll use for the Novavax COVID-19 vaccine booster, once that vaccine gets EUA or approval from the FDA. The new code is 0044A 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/0.5 mL dosage; booster dose.
The booster dose admin code shares the first part of its descriptor (including dosage amount) with the admin codes for the first dose (0041A) and second dose (0042A). All of those admin codes pair with vaccine supply code 91304. While the age range for the Novavax vaccine product (91304) has been lowered to 12 years of age, the booster dose age range is currently 18 years and older, according to the 2022 CPT® Assistant, Special Edition: October Update.
AMA also updated the CPT® appendix dedicated to COVID-19 vaccines to include 0044A. The appendix features a table with columns for the vaccine code, descriptor, admin codes, patient age, vaccine manufacturer, vaccine name, national drug code (NDC), and dosing interval.
EUAs for Bivalent Boosters:
The FDA has amended the EUAs of the bivalent Moderna COVID-19 vaccine and bivalent Pfizer-BioNTech COVID-19 vaccine to allow them as a booster dose for younger patients.
For the Moderna booster in children ages 6 to 11, you should use these codes:
91314 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use.
0144A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, booster dose
For the Pfizer-BioNTech booster in children ages 5 to 11, you should report the following:
91315 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use
0154A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, booster dose
For older pediatric patients, the 2022 CPT® Assistant, Special Edition: October Update shares the news that the age range for the Moderna bivalent booster product (91313) has been lowered to 12 years and older. This is a change from the initial age range of 18 years and older. The Pfizer-BioNTech bivalent booster (91312) is available for patients aged 12 and older.
For more information, visit: https://www.aapc.com/blog/86360-covid-19-new-novavax-booster-code-and-amended-pediatric-bivalent-booster-euas/
