If your practice plans to administer and bill for the new vaccines, it is time to prepare to document vaccination procedures in your EHR & Practice Management system. Your NextGen EHR and EPM can help you chart, track, and get reimbursed for each COVID-19 vaccination, but you will need to make some updates. 

Here is the information you need to get started administering, documenting, and billing for COVID-19 vaccines.

COVID-19 Vaccines Are Available

Pfizer-BiontechModerna, and Johnson & Johnson have promising results from their COVID-19 vaccine trials. Pfizer-Biontech has received FDA approval for ages 16 and over. Moderna and Johnson & Johnson have received Emergency Use Authorization from the US Food and Drug Administration (FDA).

If your practice expects to administer vaccines to patients, now is the time to start planning. Your practice will need to update your NextGen EHR and EPM to chart and bill for COVID-19 vaccines. You will need to regularly install Medication Module updates to keep updated with al. However, NextGen is planning to release a Medication Module update imminently, so you won't have to. This will place the new vaccines in File Maintenance so you can configure them in the NextGen Order Module.

Key Codes You Need

Charting and billing for COVID-19 vaccines start with proper codes. There are three types of codes you need to know to update your NextGen EHR and EPM to administer the vaccine: the National Drug Code (NDC), the CVX code, and the Current Procedural Terminology (CPT) code.

Each manufacturer will have different codes as they release their vaccines, so keeping your system current will be critical for clinical documentation and indications. You will need to administer the same vaccine brand to a patient for the first and second doses.

An NDC is a universal identifier for a drug approved by the FDA. The NDC identifies the vaccine product, the manufacturer, and the packaging or dosage. The NDC codes for the COVID-19 vaccines are:

  • 80777-273-99: Moderna COVID-19 Vaccine (Unit of Sale)
  • 80777-0273-10: Moderna COVID-19 Vaccine (Unit of Use)
  • 59267-1000-2: Pfizer-Biontech COVID-19 Vaccine (Unit of Sale)
  • 59267-1000-01: Pfizer-Biontech COVID-19 Vaccine (Unit of Use)
  • 0310-1222-15: AstraZeneca COVID-19 Vaccine (Unit of Sale)
  • 0310-1222-10: AstraZeneca COVID-19 Vaccine (Unit of Use)
  • 59676-580-05: Johnson & Johnson/Janssen Vaccine (Unit of Sale)
  • 59676-580-15 Johnson & Johnson/Janssen Vaccine (Unit of Use)

A CVX code identifies the vaccine product. For COVID-19 vaccines:

  • 207: Moderna vaccine CVX code 
  • 208: Pfizer-Biontech (diluent reconstituted) vaccine CVX code
  • 217: Pfizer-Biontech (tris-sucrose formulation), adult vaccine CVX code
  • 218: Pfizer-Biontech (tris-sucrose formulation), 5-11 years vaccine CVX code
  • 210: AstraZeneca vaccine CVX code
  • 212: Johnson & Johnson/Janssen vaccine CVX code

A CPT code identifies a procedure performed by a physician. Vaccine CPT codes are used to document and bill for the vaccination procedure. The Category I CPT codes and descriptions currently available for the vaccines are:

  • 91300: Pfizer-Biontech - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mLdosage, diluent reconstituted, for intramuscular use
  • 91305: Pfizer-Biontech -Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
  • 91301: Moderna - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use
  • 91306: Moderna - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use (booster)
  • 91303: Johnson & Johnson/Janssen - 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/0.5mL dosage, for intramuscular use

The American Medical Association (AMA) has also developed administration CPT codes in cooperation with the Centers for Medicare and Medicaid Services (CMS). These administration CPT codes allow for more granular tracking and reporting on COVID-19 vaccination. Your practice should use these codes even when you provide the vaccine for free. The COVID-19 vaccine administration CPT codes will also help you differentiate between delivery of the first and second doses of these two-dose products:

  • 0001A: Pfizer-Biontech: diluent reconstituted - first dose
  • 0002A: Pfizer-Biontech: diluent reconstituted - second dose
  • 0003A: Pfizer-Biontech: diluent reconstituted - third dose
  • 0004A: Pfizer-Biontech: diluent reconstituted - booster
  • 0051A: Pfizer-Biontech: tris-sucrose formulation, adult - first dose
  • 0052A: Pfizer-Biontech: tris-sucrose formulation, adult - second dose
  • 0053A: Pfizer-Biontech: tris-sucrose formulation, adult - third dose
  • 0054A: Pfizer-Biontech: tris-sucrose formulation, adult - booster
  • 0071A: Pfizer-Biontech: tris-sucrose formulation, 5-11 years (pediatrics) - first dose
  • 0072A: Pfizer-Biontech: tris-sucrose formulation, 5-11 years (pediatrics) - second dose
  • 0011A: Moderna - first dose
  • 0012A: Moderna - second dose
  • 0013A: Moderna - third dose
  • 0064A: Moderna - booster
  • 0031A: Johnson & Johnson/Janssen - single dose  
  • 0034A: Johnson & Johnson/Janssen - booster 

Updating NextGen for COVID-19 Vaccines

NextGen will incorporate the COVID-19 vaccines’ CPT, NDC, and CVX codes in the CPT code & Medication Module update. As new vaccines are released, you will need to continue to keep the Medication Module continuously updated. Make sure you also add the codes into your Service Item Library once the CPTs are available.

Not every practice has the internal resources to develop a plan for administering COVID-19 vaccine codes, however. TempDev’s developers have extensive experience programming NextGen to meet the needs of ambulatory care practices. If you need programming help to get started charting and billing for COVID-19 vaccines, call TempDev.

COVID-19 Vaccine Clinic Template

If your practice plans on providing a COVID-19 vaccine clinic where you will be charting a high volume of vaccines, contact TempDev for a demo of their NextGen EHR COVID-19 Vaccine Clinic Template!  

How TempDev Can Help

TempDev’s developers specialize in NextGen. If you need help developing a strategy, charting, or billing for vaccines, reach out to us. We have experience developing templates like the COVID-19 Testing Clinic Template and Flu Clinic Template and know how to plan for high volume tasks. We can help you design an effective COVID-19 vaccine charting and billing workflow with NextGen. 

Call us at 888.TEMP.DEV today or contact us here to get started updating your NextGen EHR for the COVID-19 vaccines. 

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