New COVID-19 Vaccine Codes; Sticky Issues Ahead

The COVID Vaccine Provider Toolkit provides the most current list of codes, payment allowances, and effective dates.

The coding news was so important that announcement appeared twice – the Centers for Medicare & Medicaid Services (CMS) MLN Connects and also in the Federal Register.

There are now new COVID-19 vaccine and vaccine administration codes. And the Federal Register also published the September 13 and 14 Coordination and Maintenance Committee meeting agenda.

The MLN Connects announcement included vaccine and administration codes. These three codes became effective July 13, 2022. The CPT® code for the Novavax vaccine is 91304 which is described as a COVID-19 vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 ml dosage for intramuscular use. Code 0041A is assigned for the administration of the first dose of the Novavax vaccine. Code 0042A covers the second dose administration of the Novavax vaccine.

Remember to visit the COVID Vaccine Provider Toolkit for the most current list of codes, payment allowances, and effective dates.

The July 22 Federal Register published the tentative agendas for the Coordination and Maintenance Committee meetings which are scheduled for September 13 and 14. These meetings will be virtual. The Federal Register includes the following tentative agenda for the procedure codes:

  1. Administration of two new drugs which will not be discussed but will accept written comments.
  2. External support device for AV fistula creation
  3. Implantation of polymethyl methacrylate cranioplasty plates
  4. Insertion of transcatheter bicaval valve system
  5. Implantation of bioprosthetic femoral venous valve
  6. Intubated prone positioning
  7. X Code updates
  8. Classification updates

These subjects include four requests for New Technology Add-On Payment for FY24.

The diagnosis code topics include the following:

  1. Extraocular muscle entrapment
  2. IgA nephrology (IGAN)
  3. Inappropriate sinus tachycardia
  4. Insulin resistance syndrome
  5. Leukodystrophies
  6. Nontraumatic coma, not elsewhere classified
  7. Sickle cell retinopathy
  8. Classification updates

Please note that the website for the Coordination and Maintenance Committee meeting has not been updated with this information as of July 26. The procedure topics will be led by the Centers for Medicare and Medicaid Services (CMS).

The Centers for Disease Control and Prevention (CDC) will lead the diagnosis topics. Registration is not required.

Programming Note: Listen to Laurie Johnson’s live Coding Report every Tuesday on Talk Ten Tuesdays with Chuck Buck and Erica Remer, MD.

Resources:

COVID-19 Vaccine Provider Toolkit

July 22, 2022 Federal Register

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Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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