On Dec. 8, the U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) of the bivalent Moderna and Pfizer-BioNTech COVID-19 vaccines. Healthcare providers can now administer these boosters to patients 6 months of age and older. Here’s how to code the supply and administration of these boosters using newly released CPT codes.

Moderna: Pair 91316 With 0164A for Booster

On Nov. 16, the American Medical Association (AMA) published new codes for the booster dose of the bivalent Moderna COVID-19 vaccine for patients ages 6 months to 5 years. As a bivalent booster, the vaccine helps protect the patient from more than one strain of the virus that causes the coronavirus.

To report the supply, use 91316 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use.

For the booster administration service, report 0164A 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, 10 mcg/0.2 mL dosage, booster dose.

Pfizer: Report 91317 and 0173A for Third Dose

The AMA posted the new codes for the Pfizer-BioNTech COVID-19 bivalent vaccine on Dec. 9. While the new Moderna administration code 0164A refers to a booster dose, the new Pfizer admin code refers to a third dose: 0173A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, third dose.

The appropriate supply code to report together with 0173A is 91317 Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use.

The updated (bivalent) Pfizer-BioNTech COVID-19 vaccine may be given to children 6 months through 4 years of age as the third dose in their primary series. The first two doses are the original (monovalent) Pfizer-BioNTech COVID-19 vaccine. Continue to report those first two doses using supply code 91308 and administration codes 0081A (first dose) and 0082A (second dose).

If children 6 months through 4 years of age have already completed their three-dose primary series with the original Pfizer-BioNTech COVID-19 vaccine, they are not currently eligible for a bivalent booster dose, according to the FDA decision.

AMA has updated the CPT appendix dedicated to COVID-19 vaccines to include these codes. A table in the appendix helps you keep straight the age ranges associated with the different products, for instance reminding you to check 91314 and 0144A when the patient receiving the Moderna bivalent booster is 6 to 11 years of age. The table also includes national drug codes (NDCs) so you can confirm the CPT codes you’re reporting match the product used.

For more information, visit: https://www.aapc.com/blog/86859-fda-updates-euas-for-pediatric-bivalent-vaccines/