Covid-19 has changed the way many services operate. The medical and the healthcare industry is the biggest witness to that change. 

As the US navigates through a global pandemic, it is imperative to understand testing and treatment coding for Covid-19. Covid-19 CPT codes developed with the purpose of streamlining the testing,vaccination and add-on charges processes are crucial to being properly compensated while achieving effective and efficient inoculation for all. 

 

What are Covid-19 CPT Codes?

Current Procedural Terminology a.k.a CPT codes are the accepted medical denotation used to report Covid-19 immunizations. 

A CPT code is unique to every coronavirus vaccine. The code helps in better tracking, data collection, report, and analysis of vaccinations for better assistance in the process. It helps keep a check on the immunization process and allows the system to adapt to the need of the hour.

Created by the American Medical Association (AMA), CPT code can help determine which code needs to be reported/registered for by asking these 2 questions:

  • Name of the manufacturer or brand.
  • First or second shot-which dose is being administered.

 

COVID-19 CPT Codes for Medical Billing

Here’s a list of Covid-19 CPT codes you should know:

 

Vaccine Codes

These codes are used to report vaccine and immunization administration for SARS-CoV-2. 

  • To report the Pfizer-BioNTech, codes 91300,0001A, and 0002A are used. To report the Moderna vaccine, 91301,0011A, and 0012A are used. Effective from November 10,2020, authorization from Food and Drug Administration (FDA) is required to proceed with the vaccination.
  • Codes 91302, 0021A, and 0022A report the AstraZeneca vaccine. Published in December 17,2020, their authorization too needs FDA’s seal of approval.
  • Used to report SARS-CoV-2 vaccine and immunization process of the Janssen vaccine, Codes 91303, 0031A were published on January 19,2021. These codes were effective upon approval from the Food and Drug Administration.
  • Codes 91304, 0041A, and 0042A are employed to report the SARS-CoV-2 vaccine by Novavax. Published on May 4, 2021, their usage is dependent on approval from the FDA.

 

Non-Vaccine Codes

  • 0202U is used to report the 2.1 BioFire Respiratory Panel Test. It was brought into effect on May 20,2020.
  • 86318 is for immunoassay for IES aka Infectious Agent Antibody.  Effective April 10,2020, the revised code, to be the parent of code 86328, includes a single-step and multi-step antibody testing for SARS-CoV-2.
  • 86408 & 86409 is used to report SARS-CoV-2 by neutralizing antibody screen and titer. Effective August 10, 2020, 2 PLA new codes were added to help with the detection process of SARS-CoV-2. They are 0225U and 0226U.
  • 87426 is used to report the detection of infectious agent antigen through the immunoassay technique of both SARS-CoV and SARS-CoV-2. 2 PLA Codes 0223U and 0224U were added to help detect SARS-CoV-2 better.
  • 87428 is used to report multiplex viral pathogen panels for SARS-CoV-2 along with Influenza A & B by using the antigen immunoassay technique.
  • 87635 reports infectious agent detection by DNA or RNA. Effective March 13,2020, the SARS-CoV-2 aka Severe Acute Respiratory Syndrome Coronavirus 2 used the amplified probe technique.
  • 87636 is used to report respiratory virus multiplex testing for both SARS-CoV-2 and Influenza A&B. Code 87637 is used to report combined respiratory virus multiplex testing for SARS-CoV-2 with Influenza A&B along with RSV. 
  • In addition, code 87811 is used for antigen detection by direct visual observation of SARS-CoV-2. 
  • 2 PLA codes 0240U and 0241U are accepted for SARS-CoV-2, Influenza A&B detection.
  • 99072 is dedicated to additional supplies and staff power required during a public health emergency to assuage the transmission of infectious respiratory diseases during procedure and treatment. An additional code called 86413 was used to report significant antibody detection of SARS-CoV-2.

 

You can visit the website for more information. This page has been updated according to the AMA and the codes are detailed accordingly.

When it comes to the pandemic, being misinformed is not something we can afford or take lightly. Remain aware of Covid-19 CPT codes for medical billing to stay safe at all times.

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