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| Short Descr | ADM SARSCV2 BVL 30MCG/.3ML A | Medium Descr | IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL | Long Descr | Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, additional dose | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. |
| GW | Service not related to the hospice patient's terminal condition | CR | Catastrophe/disaster related | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | FS | Split (or shared) evaluation and management visit | GA | Waiver of liability statement issued as required by payer policy, individual case | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | JZ | Zero drug amount discarded/not administered to any patient | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | SA | Nurse practitioner rendering service in collaboration with a physician | SE | State and/or federally-funded programs/services | SK | Member of high risk population (use only with codes for immunization) | SL | State supplied vaccine | U6 | Medicaid level of care 6, as defined by each state | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2025-01-01 | Deleted | First appearance of code deletion in codebook. |
| 2024-01-01 | Added | First appearance in codebook. |
| 2023-11-01 | Deleted | Code deleted. To report administration of COVID-19 vaccine, use 90480. |
| 2023-05-01 | Note | Changes made to dosing information |
| 2023-04-18 | Changed | Change released to AMA website on 2023-05-01. Retroactive to 2023-04-18. |
| 2023-04-18 | Note | AMA guideline changed to include 0121A. Published to website 2023-05-01. Received FDA approval effective retroactively to 2023-04-18. |
| 2023-04-18 | Note | These codes (previously associated with 0124A) are no longer authorized for use in the United States: 91300, 91305, 91307, 91308. |
| 2022-12-08 | Note | AMA guideline changed to include 91317. Published to website 2022-12-09. Received FDA approval effective retroactively to 2022-12-08. |
| 2022-10-12 | Note | AMA Guideline changed. 91315 received FDA approval. |
| 2022-08-31 | Note | AMA guideline added to include 91312; Published on AMA website and received FDA approval effective immediately. |
| 2022-08-31 | Note | AMA guideline changed to include 91315 effective upon receiving Emergency Use Authorization or approval from the FDA. |
| 2022-08-31 | Note | AMA guideline codes 91300, 91305, 91307, 91308. published to website & received FDA approval prior to the addition of 0074A. |
| 2022-08-31 | Added | Code added. Received FDA approval effective immediately. |
| 2022-08-31 | Note | Changes made to vaccine name, product & dosing information, & patient age (12+). |