© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 91315 refers to a specific formulation of the COVID-19 vaccine designed to provide immunity against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the disease known as COVID-19. This vaccine utilizes a bivalent approach, meaning it contains messenger RNA (mRNA) components that correspond to both the original strain of the virus and the omicron variant, specifically targeting the BA.4 and BA.5 subvariant lineages. The vaccine is preservative-free and is delivered in a dosage of 10 mcg per 0.2 mL, which is suitable for intramuscular administration. The mRNA is encapsulated in lipid nanoparticles (mRNA-LNP), allowing for effective delivery into the body's cells. Upon administration, the cells utilize the mRNA to produce the viral spike protein, which is recognized by the immune system as foreign, prompting the production of antibodies. This immune response is crucial for protecting individuals from severe illness upon exposure to the virus. The vaccine is specifically indicated for children aged 5 through 11 years who have previously received COVID-19 vaccinations. It is important to note that the preparation of this vaccine involves diluting it with preservative-free normal saline to achieve the correct dosage for pediatric patients. The TRIS-sucrose formulation includes buffering agents that help stabilize the vaccine and maintain its pH, ensuring its efficacy and safety when administered.
© Copyright 2025 Coding Ahead. All rights reserved.
The CPT® Code 91315 is indicated for the following:
The administration of the COVID-19 vaccine under CPT® Code 91315 involves several key procedural steps:
Post-procedure care for the administration of the COVID-19 vaccine under CPT® Code 91315 includes monitoring for any potential side effects, which may include mild reactions such as soreness at the injection site, fatigue, or low-grade fever. Patients and caregivers are advised to report any unusual or severe reactions to healthcare providers. It is also important to inform patients about the need for follow-up vaccinations as per the recommended vaccination schedule to ensure continued protection against COVID-19.
| Short Descr | SARSCOV2 VAC BVL 10MCG/0.2ML | Medium Descr | 5 SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE | Long Descr | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use | 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 | Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 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. See 91318, 91319, 91320, 91321, 91322. |
| 2023-04-18 | Note | AMA guideline changed to include 0121A, 0151A, 0171A, & 0172A. Published to website 2023-05-01. Received FDA approval effective retroactively to 2023-04-18. |
| 2023-04-18 | Note | These codes (included in the guidelines) are no longer authorized for use in the United States: 0001A, 0002A, 0003A, 0004A, 0051A, 0052A, 0053A, 0054A, 0071A, 0072A, 0073A, 0074A, 0081A, 0082A, 0083A. |
| 2023-04-18 | Note | Changes made to dosing information. |
| 2023-03-14 | Note | AMA guideline changed to include 0174A. Published to website 2023-03-17. Received FDA approval effective retroactively to 2023-03-14. |
| 2022-12-08 | Note | AMA guideline changed to include 0173A. Published to website 2022-12-09. Received FDA approval effective retroactively to 2022-12-08. |
| 2022-10-12 | Added | FDA approval received. |
| 2022-10-12 | Note | AMA Guideline changed. 0154A received FDA approval. |
| 2022-08-31 | Added | Published on AMA website. Effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2022-08-31 | Note | AMA guideline changed to include 0124A, 0154A effective upon receiving Emergency Use Authorization or approval from the FDA. |
| 2022-08-31 | Note | AMA guideline includes 0001A, 0002A, 0003A, 0004A, 0051A, 0052A, 0053A, 0054A, 0071A, 0072A, 0073A, 0074A, 0081A, 0082A, 0083A: Published on AMA website & received FDA approval prior to the addition of 91312. |
| 2022-08-31 | Note | AMA Guideline changed. 0124A received FDA approval effective immediately. |
Get instant expert-level medical coding assistance.