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Coding Guidelines for COVID-19 Treatment and Vaccination September 30, 2021

icd10 code for covid19

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:

XW013S6 XW013T6 XW013U6 XW023S6 XW023T6 XW023U6
Introduction of COVID-19 vaccine dose one into the subcutaneous tissue, percutaneous approach, new technology group 6Introduction of COVID-19 vaccine dose two into the subcutaneous tissue, percutaneous approach, new technology group 6Introduction of COVID-19 vaccine into the subcutaneous tissue, percutaneous approach, new technology group 6Introduction of COVID-19 vaccine dose one into muscle, percutaneous approach, new technology group 6Introduction of COVID-19 vaccine dose two into muscle, percutaneous approach, new technology group 6Introduction of COVID-19 vaccine into muscle, percutaneous approach, new technology group 6

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.

XW013F5Introduction of other new technology monoclonal antibody into subcutaneous tissue, percutaneous approach, new technology group 6
XW013K6Introduction of leronlimab monoclonal antibody into subcutaneous tissue, percutaneous approach, new technology group 6
XW013S6Introduction of COVID-19 vaccine dose 1 into subcutaneous tissue, percutaneous approach, new technology group 6
XW013T6Introduction of COVID-19 vaccine dose 2 into subcutaneous tissue, percutaneous approach, new technology group 6
XW013U6Introduction of COVID-19 vaccine into subcutaneous tissue, percutaneous approach, new technology group 6
XW023S6Introduction of COVID-19 vaccine dose 1 into muscle, percutaneous approach, new technology group 6
XW023T6Introduction of COVID-19 vaccine dose 2 into muscle, percutaneous approach, new technology group 6
XW023U6Introduction of COVID-19 vaccine into muscle, percutaneous approach, new technology group 6
XW033E6Introduction of etesevimab monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
XW033F6Introduction of bamlanivimab monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
XW033G6Introduction of REGN-COV2 monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
XW033H6Introduction of other new technology monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
XW033L6Introduction of CD24Fc immunomodulator into peripheral vein, percutaneous approach, new technology group 6
XW043E6Introduction of etesevimab monoclonal antibody into the central vein, percutaneous approach, new technology group 
XW043F6Introduction of bamlanivimab monoclonal antibody into central vein, percutaneous approach, new technology group 6
XW043G6Introduction of REGN-COV2 monoclonal antibody into central vein, percutaneous approach, new technology group 
XW043H6Introduction of other new technology monoclonal antibody into central vein, percutaneous approach, new technology group 6
XW043L6Introduction of CD24Fc immunomodulator into central vein, percutaneous approach, new technology group 6
XW0DXM6Introduction of baricitinib into mouth and pharynx, external approach, new technology group 6
XW0G7M6Introduction of baricitinib into upper GI, via natural or artificial opening, new technology group 6
XW0H7M6Introduction of baricitinib into lower GI, via natural or artificial opening, new technology group 6

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.

Vaccine CodeVaccine NameVaccine Administration CodeManufacturerNDC 10/ NDC 11
91300Pfizer-BioNTech COVID-19 Vaccine0004A (Booster)Pfizer, Inc59267-1000-1 59267-1000-01
91300Pfizer-BioNTech COVID-19 Vaccine0001A (1st Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91300Pfizer-BioNTech COVID-19 Vaccine0002A (2nd Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91300Pfizer-BioNTech COVID-19 Vaccine0003A (3rd Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91301Moderna COVID-19 Vaccine0011A (1st Dose)Moderna, Inc80777-273-10 80777-0273-10
91301Moderna COVID-19 Vaccine0012A (2nd Dose)Moderna, Inc80777-273-10 80777-0273-10
91301Moderna COVID-19 Vaccine0013A (3rd Dose)Moderna, Inc80777-273-10 80777-0273-10
91302AstraZeneca COVID-19 Vaccine0021A (1st Dose)AstraZeneca0310-1222-10 00310-1222-10
91302AstraZeneca COVID-19 Vaccine0022A (2nd Dose)AstraZeneca0310-1222-10 00310-1222-10
91303Janssen COVID-19 Vaccine0031A (Single Dose)Janssen59676-580-05 59676-0580-05
91304Novavax COVID-19 Vaccine0041A (1st Dose)Novavax80631-100-01 80631-1000-01
91304Novavax COVID-19 Vaccine0042A (2nd Dose)Novavax80631-100-01 80631-1000-01
91305Pfizer-BioNTech COVID-19 Vaccine0054A (Booster)Pfizer, Inc59267-1000-1 59267-1000-01
91305Pfizer-BioNTech COVID-19 Vaccine0051A (1st Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91305Pfizer-BioNTech COVID-19 Vaccine0052A (2nd Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91305Pfizer-BioNTech COVID-19 Vaccine0053A (3rd Dose)Pfizer, Inc59267-1000-1 59267-1000-01
91306Moderna COVID-19 Vaccine0064A (Booster)Moderna, Inc80777-273-10 80777-0273-10
Source: American Medical Association (AMA)

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.”

Pfizer-BioNTech Vaccine 
91300:SARSCOV2 VAC 30MCG/0.3ML IM
0001A:ADM SARSCOV2 30MCG/0.3ML 1ST
0002A:ADM SARSCOV2 30MCG/0.3ML 2ND
0003A:ADM SARSCOV2 30MCG/0.3ML 3RD 
Moderna COVID-19 Vaccine 
91301:SARSCOV2 VAC 100MCG/0.5ML IM 
0011A:ADM SARSCOV2 100MCG/0.5ML 1ST
0012A:ADM SARSCOV2 100MCG/0.5ML 2ND
0013A:ADM SARSCOV2 100MCG/0.5ML 3RD
Janssen COVID-19 Vaccine 
91303:SARSCOV2 VAC AD26 .5ML IM
0031A:ADM SARSCOV2 VAC AD26 .5ML

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.

Vaccine CPT CodeICD-10 CodeVaccine NameVaccine Admin Code(s)Unit of CoverageNDC 11 Digit Product ID 
91300Z23Pfizer BioNTech COVID-19 Vaccine0001A (1st dose)

0002A (2nd dose) 

0003A (3rd dose)
0.3mL59267-1000-01 59267-1000-02 59267-1000-03 
NDC Units reported as “UN1”
91301Z23Moderna COVID-19 Vaccine 00011A (1st dose) 

0012A (2nd dose) 

0013A (3rd dose)
0.5mL80777-0273-10 80777-0273-99 
NDC Units reported as “UN1”
91303Z23Janssen COVID-19 Vaccine0031A0.5mL59676-0580-05 59676-0580-15 
NDC Units reported as “UN1”

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 click here.

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.

At 5 Star Billing Billing Services Inc, we offer the highest level of performance for high-quality medical billing and coding. Save your money by outsourcing to a professional billing service.

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