How to code patients' second COVID-19 booster shots 

The Centers for Disease Control and Prevention now recommends that people over 50 and those who have certain immunocompromising conditions receive a second mRNA booster shot for COVID-19 if it has been at least four months since their previous dose. But what CPT code should you report for these shots?

Up until now, each dose of mRNA COVID-19 vaccine came with its own administration code. That’s not the case with the second booster. You should use the same administration code for each booster dose, whether it’s the patient’s first or second.

For example, if you administer a second booster of the Pfizer vaccine (CPT code 91300) you would report administration code 0004A, “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, 30 mcg/0.3 mL dosage, diluent reconstituted; booster dose.”

As you can see, the descriptor for code 0004A simply refers to “booster dose” and does not specify first or second. As such, it may be used for either booster, and it’s the same for the other COVID-19 vaccines. 

— Kent Moore, senior strategist for physician payment, American Academy of Family Physicians

Posted on April 12, 2022, by Kent Moore