© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 91322 refers to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, specifically the mRNA-LNP formulation, which is designed for intramuscular use. This vaccine is crucial in providing protection against COVID-19, a disease caused by the SARS-CoV-2 virus, which can lead to severe and potentially life-threatening health complications. The vaccine utilizes messenger RNA (mRNA) technology, where strands of mRNA are encapsulated in lipid nanoparticles (LNP). This innovative approach allows the mRNA to instruct the body's cells to produce a protein that mimics the spike protein found on the surface of the coronavirus. By doing so, the immune system is prompted to recognize this protein as foreign, leading to the production of antibodies that can effectively combat the virus upon exposure. The specific formulation referenced by this code encodes for the spike protein of the SARS-CoV-2 Omicron variant lineage XBB.1.5. Administered intramuscularly, this vaccine does not require additional adjuvants to enhance the immune response, as the lipid nanoparticle system facilitates the uptake of mRNA by the cells. This code is specifically for reporting the supply of the Moderna COVID-19 vaccine at a dosage of 50 mcg/0.5 mL, intended for individuals aged 12 years and older. The formulation includes buffering agents that stabilize the vaccine and maintain its pH, allowing for storage at standard refrigerator temperatures. It is important to note that the administration of the vaccine is reported separately from the supply code.
© Copyright 2025 Coding Ahead. All rights reserved.
The CPT® Code 91322 is indicated for the administration of the SARS-CoV-2 (COVID-19) vaccine, specifically for individuals who are at risk of contracting the virus and developing COVID-19. The vaccine is recommended for:
The procedure for administering the COVID-19 vaccine under CPT® Code 91322 involves several key steps to ensure proper delivery and effectiveness of the vaccine. Each step is critical to the overall success of the vaccination process.
Post-procedure care following the administration of the COVID-19 vaccine involves providing the patient with information regarding potential side effects, which may include soreness at the injection site, fatigue, headache, muscle pain, chills, fever, and nausea. Patients should be advised to report any severe or unusual reactions to their healthcare provider. Additionally, patients may be instructed on the importance of completing the vaccination series, if applicable, and the need for follow-up appointments. It is also essential to document the administration of the vaccine in the patient's medical record, including the date, dosage, and site of injection, as well as any observed reactions during the monitoring period.
| Short Descr | SARSCOV2 VAC 50 MCG/0.5ML IM | Medium Descr | SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE | Long Descr | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use | Related Drugs | Spikevax | 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 | 1 |
| GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | JZ | Zero drug amount discarded/not administered to any patient | GC | This service has been performed in part by a resident under the direction of a teaching physician | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | SL | State supplied vaccine | KX | Requirements specified in the medical policy have been met | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CG | Policy criteria applied | CR | Catastrophe/disaster related | CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency | 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 | HA | Child/adolescent program | KS | Glucose monitor supply for diabetic beneficiary not treated with insulin | 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 | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | 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) | U6 | Medicaid level of care 6, as defined by each state | U8 | Medicaid level of care 8, as defined by each state | UA | Medicaid level of care 10, as defined by each state | UC | Medicaid level of care 12, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2025-01-01 | Added | First appearance of code and guideline in codebook |
| 2023-09-11 | Added | FDA Approval Received |
| 2023-08-14 | Added | Code added, effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration |
| 2023-08-14 | Note | AMA guideline code 90480 published to AMA website. Effective upon receiving emergency Use Authorization or approval from the FDA. |
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