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| Short Descr | ADM SARSCV2 BVL 50MCG/.5ML A | Medium Descr | IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 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, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | SL | State supplied vaccine | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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. | 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 | K0 | Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility. | LT | Left side (used to identify procedures performed on the left side of the body) | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | SA | Nurse practitioner rendering service in collaboration with a physician | U6 | Medicaid level of care 6, as defined by each state | 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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Date
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Action
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Notes
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| 2024-01-01 | Added | First appearance in codebook. |
| 2023-11-01 | Deleted | Code deleted. To report administration of COVID-19 vaccine, use 90480. |
| 2023-04-18 | Changed | Change released to AMA website on 2023-05-01. Rtroactive to 2023-04-18. |
| 2023-04-18 | Note | These codes (associated with 0134A) are no longer authorized for use in the United States: 91301, 91306 91309, 91311. |
| 2023-04-18 | Note | Change made to dosing information |
| 2023-01-01 | Deleted | First appearance of code deletion in codebook. |
| 2022-12-08 | Note | AMA Guideline changed. 91316 and 0164A received FDA approval. |
| 2022-11-16 | Note | AMA guideline changed. 91316 will be effective upon receiving EUA or FDA approval. |
| 2022-10-12 | Note | AMA Guideline changed. 91313 (12 yrs – 17 yrs) and 91314 both received FDA approval. |
| 2022-10-12 | Added | 0134A (12 yrs –17) recieved FDA approval. |
| 2022-10-12 | Note | AMA Guideline changed. 0144A received FDA approval. |
| 2022-10-10 | Note | Code 0134A is awaiting Emergency Use Authorization or approval from the FDA for ages 12 years through 17. |
| 2022-08-31 | Added | Published on AMA website and received FDA approval effective immediately for years 18 and older. |
| 2022-08-31 | Note | AMA guidelines include 91314 effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2022-08-31 | Note | AMA guideline codes 91301, 91306, 91309, 91311: Published on website & received FDA approval prior to the addition of 0134A. |
| 2022-08-31 | Added | AMA Guideline changed. 91313 (18 yrs & older) received FDA approval effective immediately. |