How To Use CPT Code 91302

CPT 91302 describes the administration of a DNA-based vaccine to prevent the patient from contracting COVID-19. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 91302?

CPT 91302 represents the administration of a DNA-based vaccine that targets the spike protein of the SARS-CoV-2 virus, which causes COVID-19. This vaccine is delivered via intramuscular injection and is designed to reduce the patient’s risk of contracting COVID-19. The dosage of the vaccine is 5×10¹⁰ viral particles/0.5 mL.

2. Official Description

The official description of CPT code 91302 is: ‘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5×10¹⁰ viral particles/0.5 mL dosage, for intramuscular use.’

3. Procedure

1. The healthcare provider administers the DNA-based vaccine to the patient via intramuscular injection.
2. The vaccine contains a modified version of a chimpanzee adenovirus that carries the gene for the spike protein of the SARS-CoV-2 virus.
3. After injection, the adenoviruses enter cells and instruct them to produce spike proteins.
4. These spike proteins trigger an immune response in the patient, helping to protect them from COVID-19.
5. The dosage of the vaccine is 5×10¹⁰ viral particles/0.5 mL.

4. Qualifying circumstances

CPT 91302 is used for patients who are at risk of contracting COVID-19 and need to be vaccinated. The vaccine is preservative-free and uses a DNA-based approach with a chimpanzee adenovirus vector. It is important to note that this code should only be used for the administration of the vaccine and not for any other services or procedures related to COVID-19.

5. When to use CPT code 91302

CPT code 91302 should be used when a healthcare provider administers the DNA-based vaccine for COVID-19 prevention. It is important to ensure that the vaccine administered matches the description provided in the code. This code should not be used for any other vaccines or treatments.

6. Documentation requirements

To support a claim for CPT 91302, the healthcare provider must document the following information:

• Patient’s eligibility for the COVID-19 vaccine
• Date and time of the vaccine administration
• Route of administration (intramuscular)
• Dosage of the vaccine (5×10¹⁰ viral particles/0.5 mL)
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 91302, ensure that the vaccine administered matches the description provided in the code. It is important to use the appropriate administration codes (0021A for the first dose and 0022A for the second dose) in conjunction with CPT 91302. Additionally, be aware of any specific guidelines or requirements from insurance companies or government programs regarding the billing of COVID-19 vaccines.

8. Historical information

CPT 91302 was added to the Current Procedural Terminology system upon receiving Emergency Use Authorization or approval from the Food and Drug Administration. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider administering the DNA-based COVID-19 vaccine to a patient to reduce their risk of contracting the virus.
2. A nurse administering the first dose of the DNA-based COVID-19 vaccine to a patient.
3. A pharmacist administering the second dose of the DNA-based COVID-19 vaccine to a patient.
4. A healthcare provider administering the DNA-based COVID-19 vaccine to a patient who is at high risk of severe illness from COVID-19.
5. A healthcare provider administering the DNA-based COVID-19 vaccine to a patient as part of a community vaccination program.
6. A nurse administering the DNA-based COVID-19 vaccine to a patient in a long-term care facility.
7. A healthcare provider administering the DNA-based COVID-19 vaccine to a patient with a history of allergic reactions to other vaccines.
8. A pharmacist administering the second dose of the DNA-based COVID-19 vaccine to a patient who received the first dose from a different provider.
9. A healthcare provider administering the DNA-based COVID-19 vaccine to a patient who is planning to travel internationally.
10. A nurse administering the first dose of the DNA-based COVID-19 vaccine to a patient who has recovered from a previous COVID-19 infection.