The American Medical Association (AMA) stated that the Current Procedural Terminology (CPT®) code set is available for the third dose of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has accelerated approval of a new control code specific to the third dosage of Moderna’s existing COVID-19 vaccine. On July 30, the AMA published a new administration code for the third dosage of Pfizer’s existing COVID-19 vaccine because the US Food and Drug Administration (FDA) has permitted third doses of COVID-19 vaccines from Pfizer and Moderna for some persons with impaired immune systems.
The Centers for Disease Control and Prevention suggested that moderately to severely immunocompromised patients have a third dose of the Pfizer or Moderna COVID-19 vaccine.
What Should You Know?
- If you have a weaker immune system, you are at a higher risk of severe COVID-19 sickness and death. Furthermore, your immune response to COVID-19 immunization may be less than those who are not immunocompromised.
- As with other vaccinations, you are most protected if you keep your COVID-19 immunizations up to date, as detailed below.
- You may be eligible for Evusheld (a medicine used to prevent COVID-19 in adults and adolescents), a treatment administered by your healthcare physician to help avoid COVID-19.
- You can self-certify if you are mildly or severely immunocompromised. That implies that you do not need to provide any proof of your status to acquire COVID-19 vaccination doses wherever they are available.
Children who are immuno-suppressed, moderately or severely.
To keep up to date, children aged 5 to 11 years who are slightly or severely immunocompromised should take the main series of three doses of Pfizer-BioNTech COVID-19 vaccine on the schedule described below. At this time, a booster is not suggested for this age range.
Preteens, Teens, and Adults Who Are Immunocompromised Moderately or Severely
To keep up to date, anyone aged 12 and up who is slightly or severely immunocompromised should get four doses of mRNA COVID-19 vaccination. The four doses consist of a primary series of three doses of Pfizer-BioNTech or Moderna COVID-19 vaccine, plus one booster dose of Pfizer-BioNTech or Moderna COVID-19 vaccine (4th dosage), as illustrated below. Only the Pfizer-BioNTech COVID-19 vaccination is available for youth ages 12–17.
COVID-19 PRIMARY SERIES VACCINE
5–11 years Age Group of Pfizer-BioNTech
- For completion of primary series three doses are required.
- The second dosage was administered three weeks (21 days) following the first dose.
- The third dosage is administered at least four weeks (28 days) following the second dose.
Timing and Booster:
At this moment, it is not suggested.
First and Second Dose for Pfizer
Pfizer 0001A: Intramuscular administration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The CPT code 0001A COVID-19 vaccine is only for the first dosage of the Pfizer vaccine.
Pfizer 0002A: Administration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) The CPT code 0002A COVID-19 vaccine is only for the second dosage of the Pfizer vaccine.
First and Second Dose for Moderna
Moderna 0011A: Immunization delivery by intramuscular injection of SARS-CoV-2. The CPT code 0011A vaccine administration is only for the first dose of the Moderna vaccine.
Moderna 0012A: Immunization delivery through intramuscular injection of SARS-CoV-2. The CPT code 0012A vaccine administration is only for the second dose of the Moderna vaccine.
Who Is Immunocompromised Moderately or Severely?
People are classified as moderately or severely immunocompromised (having a reduced immune system) due to a variety of illnesses and treatments. Here are several examples:
- Been undergoing ongoing cancer therapy for tumors or blood cancers
- After an organ transplant and are receiving immunosuppressive medication
- Chimeric antigen receptor (CAR)-T-cell treatment was administered (a treatment to help your immune system attach to and kill cancer cells) or had a stem cell transplant (within the last two years)
- Primary immunodeficiency is moderate or severe (DiGeorge syndrome and Wiskott-Aldrich syndrome).
- HIV infection that is advanced or untreated.
- Active therapy with corticosteroids at high doses or other medicines may reduce their immune response.
Discuss the COVID-19 vaccine and your medical issue with your healthcare practitioner.
If you are immunocompromised or sensitive to COVID-19 immunizations, you may be qualified for Evusheld, a medication administered by your healthcare professional to assist you in obtaining COVID-19. Consult your healthcare physician to see whether this is a possibility for you.
Conclusion
For additional information about medical coding for COVID-19 vaccines, please contact us. We are an industry leader in medical billing and coding services. Our experience in various medical billing disciplines ensures that insurance reimbursements are processed quickly and accurately. For more information on our medical billing and coding services, please contact us at rcmexpertz@gmail.com.
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