Reimbursement News

CPT Code Set Adds Code for J&J COVID-19 Vaccine Booster

AMA updated the CPT code set to accommodate the new mix-and-match COVID-19 vaccine booster strategy endorsed by the federal government.

AMA updates CPT code set to add COVID-19 vaccine booster from Janssen

Source: American Medical Association/Xtelligent Healthcare Media

By Jacqueline LaPointe

- The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a new code for COVID-19 vaccine booster doses of the vaccine created by Janssen Pharmaceutical Companies, a division of Johnson & Johnson.

The update comes on the heels of a decision from the Federal Drug Administration (FDA) to authorize booster doses of Janssen’s COVID-19 vaccine. The federal agency has recommended a booster dose of the vaccine for adults who received the single-dose vaccine at least two months earlier or for eligible adults at least six months following the second dose of an authorized mRNA vaccine.

The authorization is part of the new mix-and-match strategy endorsed by both the FDA and the Centers for Disease Control and Prevention (CDC) to boost protection against COVID-19 and its new, highly contagious strains.

“We believe the FDA’s authorization and the CDC's recommendations in support of booster doses, including the option to mix-and-match boosters with authorized vaccines, will help provide continued protection against COVID-19 for those who need it most,” Gerald E. Harmon, MD, president of the AMA, said in a press release on Wednesday.

AMA assigned code 0034A to the COVID-19 vaccine booster dose from Janssen. The code is as follows:

0034A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; booster dose

The CPT code is added to the now 28 Category I codes added to the CPT code set to report COVID-19 immunizations.

AMA previously issued CPT codes for COVID-19 vaccine booster doses from Moderna and Pfizer. The CPT codes for documenting COVID-19 vaccine booster doses from Janssen and Moderna went into effect for use by providers on Oct. 20th, while the codes for Pfizer boosters were effective as of Sept. 22nd. The effective dates correlate with the emergency use authorizations issued by the FDA, AMA pointed out.

The new CPT code for the Janssen COVID-19 vaccine booster dose will be part of the CPT code set update for 2023. But healthcare providers are able to use codes released early by the AMA by uploading descriptors to their EHR systems.