New provisional code created for potential third dose of Pfizer vaccine

The American Medical Association (AMA) today announced that the Current Procedural Terminology (CPT^®) code set has been updated by the CPT Editorial Panel to include a new  administration code that is unique to a potential third dose of the current COVID-19 vaccine offered by Pfizer.

The provisional CPT code will be effective for use on the condition that a third dose shot of the Pfizer COVID-19 vaccine receives regulatory approval or authorization from the U.S. Food and Drug Administration (FDA). The AMA is publishing the CPT code update now to ensure electronic systems across the U.S. health care system are prepared in advance if the FDA approves or authorizes a third dose of the Pfizer COVID-19 vaccine.

“The FDA and the U.S. Centers for Disease Control and Prevention (CDC) have analyzed data indicating that at this time individuals do not need to exceed the standard two doses authorized for Pfizer’s COVID-19 vaccine,” said AMA President Gerald Harmon, M.D. “The AMA supports the position of the CDC and FDA since it is based on a careful consideration of the available evidence to date. We are confident that federal health agencies will continue to review emerging evidence on a potential third dose of the Pfizer COVID-19 vaccine. The CPT code set stands ready to meet the immediate needs of the health system if third dose shots are considered necessary.” 

For quick reference, the vaccine administration CPT code and long descriptor assigned to the third dose of the current Pfizer COVID-19 vaccine is:

0003A       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; third dose

This CPT code and descriptor are used to report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record.

Short, medium and long descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SARS-CoV-2 virus and the COVID-19 disease.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.

Questions on CPT coding and content should be directed to the CPT Network, the authoritative source for CPT coding answers. Also consult the AMA online library of COVID-19 CPT coding and guidance.