New CPT codes for 3rd dose/booster COVID vaccinations

JimF · October 5, 2021, 8:19pm

Hi, below are some new CPT codes related to COVID19 vaccinations, 3rd dose/booster. Please add as soon as possible as they are important for ongoing COVID related outcome and vaccination rate studies. Thanks!

Vaccine Administration Code(s) Manufacturer Vaccine Name(s)
0003A Pfizer, Inc|Pfizer-BioNTech COVID-19 Vaccine, 3rd dose|
0004A Pfizer, Inc|Pfizer-BioNTech COVID-19 Vaccine, Booster
0013A Moderna, Inc Moderna COVID-19 Vaccine, 3rd dose

Mike_Nerovnya · October 7, 2021, 8:08pm

Hi @JimF! We will add these vaccines during the next CPT update. Thank you!

Christian_Reich · October 7, 2021, 8:28pm

@Mike_Nerovnya:

too slow, unless that update is imminent. This is for ongoing Covid vaccine research.

mik · October 7, 2021, 9:10pm

We have a full CPT4 refresh planned for this quarter. I am sure we can switch priorities and either have that full refresh rather soon or focus on those requested codes first.
It is also a good idea to create specific requests like these as a github issue, so that we can track them properly.
Thanks ~ Mik

Patrick_Ryan · October 27, 2021, 1:42pm

Team:

A quick follow-up to this. I understand AMA is ratifying multiple new CPT codes, both for boosters for Pfizer, Moderna, and Janssen, as well as for pediatric indication, in expectation of final FDA/CDC approval. Given this ‘special case’ in that multiple folks in community are actively doing vaccine research that will depend on these codes, could I ask that we please communicate as soon as we see those codes hit on the AMA side and as soon as they are available for distribution on the OHDSI/ATHENA side. It will be helpful for entire community to learn how the new codes were incorporated, what (if any) relationships we have between these CPT4 codes and RxNorm, and how we recommend folks consider using them in their study. I will commit to providing cohort definitions/conceptsets that use these new concepts when they become available, but seems clear that we’ll have to associate those study artifacts with particular vocab versions, given the rapid movement we’re seeing here.

Patrick_Ryan · October 27, 2021, 5:49pm

Adding the link that I should have provided on my last post for posterity:

AMA issued new code for Janssen booster today (Oct27), and Pfizer pediatric codes earlier on Oct6.

mik · October 28, 2021, 9:31am

Hi @Patrick_Ryan, good news!
With the latest release (I will add more information to a “What’s new” section soon) we now have those CPT4 concepts. The latest one from yesterday didn’t make it into the release though… It does exist as a code but only “reserved”. The Pfizer pediatric codes are present (91307, 0071A, and 0072A) and currently map to the RxNorm ingredient as RxNorm will provide a proper RXCUI to those vaccines only after actual official approval although an NDC already exists.
We might want to update our COVID19 wiki page to provide some guidance how these codes could or should be applied. The codes that @JimF requested exist of course, too, properly rolling up to the respective RxNorm clinical drug. See for example: 0003A. The fact which dose this particular administration represents is of course lost in the mapping and has to be preserved by other means (options on how that can be done, should go to that guidance page in the wiki).