You are subscribed to one of the following page update alerts: Vaccine Code Set Update Publication Date: September 14, 2021
The individual filenames included in this distribution contain the publication date (20210914) Release Notes: This release includes updates for all vaccine codes except Vaccine Information Statement (VIS) codes and maps.
Release notes are designed as a guide to highlight changes that have been made to the vaccine codes since the last publication. They should not be used as the primary source of code information. The vaccine code files themselves should be utilized.
General Note Regarding This Release: Codes with “Last Update” dates from August 24 through September 13, 2021 reflect the changes and additions in this release. This release includes the following code set updates:
Vaccine Code Set Updates Not Related to COVID-19
- New CPT to CVX Code Maps
- Other Vaccine Code Additions and Changes
COVID-19 Related Code Updates - Pfizer U.S. COVID-19 new NDC, CVX, and CPT code for additional products anticipating potential EUA
- Moderna CPT to CVX Map for booster dose anticipating potential EUA
Vaccine Code Set Updates Not Related to COVID-19 - New CPT to CVX codes have been added and mapped as follows:
- CPT Code 90671 “Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use” has been added and mapped to CVX Code 215 “Pneumococcal conjugate vaccine 15-valent (PCV15), polysaccharide CRM197 conjugate, adjuvant, preservative free”
- CPT Code 90677 “Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use” has been added and mapped to CVX Code 216 “Pneumococcal conjugate vaccine 20-valent (PCV20), polysaccharide CRM197 conjugate, adjuvant, preservative free”
- CPT code 90758 “Zaire ebolavirus vaccine, live, for intramuscular use” has been added and mapped to CVX code 204 “Ebola Zaire vaccine, live, recombinant, 1mL dose”
- HAVRIX NDCs with labeler “A-S Medication Solutions” have been reactivated and added to CDC vaccine code set
- UoU NDC11 50090-1502-09/NDC10 50090-1502-9 is mapped to CVX code 52 “Hep A, adult”
- UoS NDC11 50090-1502-00/NDC10 50090-1502-0 is mapped to manufacturer MVX code SKB “GlaxoSmithKline”
COVID-19 Related Code Updates
The following codes have been added in anticipation of FDA EUA submission and authorization. These products could be authorized and become available over the next few months. The codes are provided in advance of FDA authorization to help systems prepare for potential product availability. If they are not authorized by the FDA, the codes will be inactivated. - Pfizer-BioNTech COVID-19 Vaccine: The following table provides new codes that have been added for potential new tris-sucrose formulation products.
| Tris-sucrose formula, 30 mcg/0.3 mL for ages 12+ |
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| Unit of Sale NDC10 | Unit of Sale NDC11 | Carton | Unit of Use NDC10 | Unit of Use NDC11 | Unit of Use Presentation |
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59267-1025-2 | 59267-1025-02 | CARTON, 195 MULTI-DOSE VIALS | 59267-1025-1 | 59267-1025-01 | VIAL, 2.25 mL, MULTI-DOSE VIAL |
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59267-1025-3 | 59267-1025-03 | CARTON, 25 MULTI-DOSE VIALS |
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59267-1025-4 | 59267-1025-04 | CARTON, 10 MULTI-DOSE VIALS |
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CVX Code | 217 | SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 30 mcg/0.3 mL dose, tris-sucrose formulation |
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MVX Code | PFR | Pfizer, Inc |
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CPT Code | 91305 | 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 |
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Tris-sucrose formula, 10 mcg/0.2 mL for ages 5 yrs to < 12 yrs |
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Unit of Sale NDC10 | Unit of Sale NDC11 | Carton | Unit of Use NDC10 | Unit of Use NDC11 | Unit of Use Presentation |
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59267-1055-2 | 59267-1055-02 | CARTON, 195 MULTI-DOSE VIALS | 59267-1055-1 | 59267-1055-01 | VIAL, 2 mL, MULTI-DOSE VIAL |
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59267-1055-4 | 59267-1055-04 | CARTON, 10 MULTI-DOSE VIALS |
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CVX Code | 218 | SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 10 mcg/0.2 mL dose, tris-sucrose formulation |
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MVX Code | PFR | Pfizer, Inc |
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CPT Code | thB | Code not yet available |
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Tris-sucrose formula, 3 mcg/0.2 mL for ages 2 yrs to < 5 yrs |
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Unit of Sale NDC10 | Unit of Sale NDC11 | Carton | Unit of Use NDC10 | Unit of Use NDC11 | Unit of Use Presentation |
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59267-0078-2 | 59267-0078-02 | CARTON, 195 MULTI-DOSE VIALS | 59267-0078-1 | 59267-0078-01 | VIAL, 2 mL, MULTI-DOSE VIAL |
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59267-0078-4 | 59267-0078-04 | CARTON, 10 MULTI-DOSE VIALS |
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CVX Code | 219 | SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 3 mcg/0.2 mL dose, tris-sucrose formulation |
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MVX Code | PFR | Pfizer, Inc |
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CPT Code | thB | Code not yet available |
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- Moderna COVID-19 Vaccine: The following code changes have been made in anticipation of FDA EUA authorization for a booster dose drawn from existing product vials.
- CVX Code 207 description has been modified to allow its use for both the current full dose and the proposed booster half dose. The new description is as follows: “SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 100 mcg or 50 mcg dose”
- An additional CPT code 91306 has been added “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”. The new CPT code has been mapped to CVX code 207.
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