This bulletin is an update to COVID-19 SPECIAL BULLETIN #257 posted July 6, 2013.
The Current Procedural Terminology (CPT®) Editorial Panel (the Panel) has approved three new vaccine administration codes (0091A, 0092A, 0093A) for the Moderna vaccine product to address severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) in pediatric patients ages 6 through 11. These codes are to be reported with previously established Moderna vaccine product code 91309.
- 91309 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use
- 0091A 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, 50 mcg/0.5 mL dosage; first dose when administered to individuals ages 6 through 11
- 0092A second dose when administered to individuals ages 6 through 11
- 0093A third dose when administered to individuals ages 6 through 11 for those moderately to severely immunocompromised
- 0094A booster dose when administered to individuals ages 18 and older
Prior to the issuance of these three new administration codes, SPECIAL BULLETIN COVID-19 #257 instructed providers to use code 0094A multiple times for billing vaccine 91309. As of July 13, 2022, providers should begin using the new codes for appropriate billing.
The Panel has also approved an additional vaccine administration code (0113A) that is to be reported with the previously established Moderna vaccine product (91311) for pediatric patients ages 6 months through 5 years.
- 91311 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 25 mcg/0.25 mL dosage, for intramuscular use
- 0111A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus (SARS-Co-V-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 25 mcg/0.25 mL dosage; first dose
- 0112A second dose
- 0113A third dose who are moderately to severely immunocompromised
- Lastly, the age for the adult Moderna vaccine product (91301) and its associated vaccine administration codes (0011A, 0012A, 0013A) has been revised from ages 18 and older to ages 12 and older. These changes are retroactively effective as of June 17, 2022, when the vaccines received emergency use authorization (EUA) from the Food and Drug Administration (FDA).
More information can be found in the CPT Assistant Special Edition: July Update.
All other aspects of NC Medicaid billing apply to these new codes.
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