Coding Guidelines for COVID-19 Treatment and Vaccination

As the COVID-19 vaccines are in operation, we compiled a list of medical codes for Coronavirus vaccination and treatment.

ICD-10 Codes for COVID-19

Last March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic outbreak. By this time, the WHO also developed ICD-10-CM codes for the Novel Coronavirus Disease (U07.1 COVID-19). The Centers for Disease Control and Prevention (CDC) adopted these codes in March 2020. Likewise, the Centers for Medicare and Medicaid Services (CMS) has developed 20 ICD-10-PCS codes for recording COVID-19 treatments and vaccines since April 2020. The six vaccine administration codes are as follows:

COVID-19 ICD-10-PCS Coding

According to CMS, the new 21 PCS codes will “describe the use of vaccines or monoclonal antibodies for COVID-19 treatment and infusion of therapeutics.” The PCS codes do not affect MS-DRG assignment.

COVID-19 Vaccine CPT Codes

You can now identify the appropriate CPT code combination to use for the type and dose of vaccine you are using. The Centers for Disease Control and Prevention (CDC) integrate these codes for their tracking needs.

Meanwhile, the Centers for Medicare & Medicaid Services (CMS) identify two code groups:

• Provides a vaccine administration code that is both a vaccine and has a specific dose.
• Help determine the type of vaccine

It is essential to choose the correct manufacturer’s vaccine code.

Medical Billing and Coding Guidelines

Coding Guidelines

In an update to the Current Procedural Terminology (CPT®) code set, the American Medical Association (AMA) included new vaccine-specific codes for reporting immunizations against the novel Coronavirus (SARS-CoV-2, COVID-19).

The specificity level allows keeping track of the vaccine dose even when you don’t report the vaccine product. For example, a patient may receive a vaccine for free. These CPT codes record the actual work of providing the vaccine, along with any necessary counseling and updating the electronic health record.”

Billing Guidelines

“The American citizens can now get free vaccine doses using taxpayer dollars. However, vaccination providers may charge administration fees for the procedure. In this case, health insurance companies can reimburse them for the amount or the Health Resources and Services Administration’s Provider Relief Fund (HRSA) if the patient is uninsured.”

Ensure you enter the appropriate CPT codes for the vaccine and the administration fee in your billing system.

In order to submit a claim to Medicare for administering the COVID-19 vaccine, providers must be Medicare-eligible. If you want to look for another reference, you can view the document here – COVID-19 Vaccine Billing and Coding Reference

Tap Into Our Expertise

The COVID-19 codes and billing guidelines are new obstacles for your medical practice. However, worrying too much cannot help your practice grow. You can always count on coding and billing experts to help you.

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