CPT Codes Created for Novavax COVID-19 Vaccine, Administration

The CPT code is the fifth created for providers to document and bill for the administration of COVID-19 vaccines, AMA announced.

The American Medical Association (AMA) has created unique Current Procedural Terminology (CPT) codes for the Novavax COVID-19 vaccine and its administration.

The vaccine from Novavax Inc. has yet to receive authorization for use in the US by the Food and Drug Administration (FDA). The vaccine called NVX-CoV2373 is currently undergoing two Phase 3 clinical trials, one of which recently expanded to include pediatric patients.

Previous data has shown the two-dose vaccine to have an efficacy rate of 96.4 percent against the original virus strain and 86.3 percent against the B.1.1.7/501Y.V1 variant. The vaccine also provides 100 percent protection against severe disease.

NVX-CoV2373 is likely to be the next to receive emergency use authorization from the FDA, skipping ahead of the long-anticipated application from AstraZeneca, according to Politico.

AMA updated the CPT code set yesterday to include new CPT codes for Novavax’s vaccine in preparation of an emergency use authorization from the FDA, according to the May 4th press release.

Novavax is now the fifth company to get their own CPT codes for their vaccine and its administration, following AstraZeneca, Janssen (Johnson & Johnson), Moderna, and Pfizer. The unique CPT codes help to identify which vaccines are being used and when, AMA stated.

“Relying on multiple manufacturers to produce different COVID-19 vaccine products helps to avoid possible supply disruptions and supports the needed volume of doses,” Susan R. Bailey, MD, president of the AMA, said in the press release. “However, accurately correlating vaccinated patients with one of the available COVID-19 vaccines is critical for managing immunizations.”

“This challenge is managed with unique CPT codes that clinically distinguish each COVID-19 vaccine and provide the needed informational precision to ensure optimal vaccine distribution and administration,” Bailey continued.

CPT code 91304 will be effective for use on the condition that the Novavax COVID-19 vaccine receives approval for emergency use authorization, AMA said in the press release.

Vaccine providers will also be able to use CPT codes 0041A and 0042A to document the administration of the first and second doses of the vaccine, respectively, upon authorization for use.

The long descriptors for the new CPT codes are:

  • 91304: 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/0.5mL dosage, for intramuscular use
  • 0041A: 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/0.5mL dosage; first dose
  • 0042A: 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/0.5mL dosage; second dose

Short, medium, and long descriptors for all the new vaccine-specific CPT codes can also be found on AMA’s website, alongside other recent modifications to the CPT code set during the COVID-19 pandemic. The codes and other modifications have been streamlined for approval by the CPT Editorial Panel in light of the public health emergency and rapidly emerging therapies for the novel coronavirus.

AMA has also created new CPT codes to describe the additional supplies and clinical staff time required to prevent the spread of the coronavirus while delivering evaluation, treatment, or procedural services during a public health emergency.

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