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New CPT Codes Released: Essential Updates for 2024-2025 Vaccine Administration

The American Medical Association (AMA) has recently unveiled several new and revised Current Procedural Terminology (CPT) codes ahead of the 2025 cycle. These updates are crucial for healthcare providers, particularly in preparation for the upcoming flu season and the introduction of new vaccines for meningitis and pneumonia. While the full list of changes will be available in the CPT 2025 manual, several key updates have already come into effect, offering a glimpse into what’s to come.

Table of Contents

Flu Vaccine Updates for 2024-2025

The Centers for Disease Control and Prevention (CDC) has confirmed that the 2024-2025 seasonal flu vaccines will be trivalent, offering protection against three strains: H1N1, H3N2, and B/Victoria. In line with this, the AMA released two new CPT codes on July 13, 2024. These codes are effective for dates of service on or after July 1, 2024, although Medicare payment allowances and vaccine release dates have not yet been finalized.

90637: Influenza virus vaccine, quadrivalent (qIRV), mRNA; 30 mcg/0.5 mL per dose, for intramuscular use
90638: Influenza virus vaccine, quadrivalent, mRNA (qIRV); 60 mcg/0.5 mL per dose; for intramuscular use

These new vaccines are still pending FDA approval, but they represent a significant advancement in flu prevention efforts for the upcoming season.

In addition to these new codes, the AMA has also updated an existing vaccine code. The revised descriptor for this code will take effect on January 1, 2025:

90661: Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures; subunit, preservative and antibiotic-free; 0.5 mL dosage; for intramuscular use

These updates highlight the ongoing evolution of flu vaccines, ensuring that healthcare providers have the tools they need to combat the seasonal flu effectively.

Other Vaccine Code Changes

The new CPT codes introduced by the American Medical Association (AMA) also reflect significant advancements in vaccines targeting other serious diseases, such as meningitis and pneumonia. These updates underscore the continuous efforts to enhance the immunization system, ensuring it remains responsive to emerging health threats.

Pneumonia Vaccines:
- 90684: Pneumococcal conjugate vaccine, 21-valent, for intramuscular use
  - This conjugate pneumococcal vaccine was licensed on June 20, 2024, and its corresponding CPT code became effective immediately. This vaccine offers broader protection against pneumococcal disease, a major cause of illness in both children and adults.
Meningitis Vaccines:
- 90624: Meningococcal Pentavalent Vaccine, Serogroups A, C, W, Y Conjugate, Recombinant
  - This new vaccine code, yet to receive FDA approval, is expected to become effective in October 2024. It represents a critical step forward in preventing meningococcal disease, a potentially life-threatening condition.

These updates demonstrate the AMA’s commitment to staying ahead of the curve in vaccine development, ensuring that healthcare providers can offer the most up-to-date and effective immunization options.

RSV Vaccine Approved by FDA

A significant milestone in vaccine development was achieved on May 31, 2024, when the FDA approved Moderna’s respiratory syncytial virus (RSV) vaccine. In response, the AMA introduced a new CPT code for this vaccine, which will be included in the CPT 2025 publication:

90683: Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use

Although the United States has a relatively low number of contracted RSV cases, the CDC acknowledges that this vaccine has a modest coverage rate. Its introduction is aimed at improving public health outcomes, particularly for those at high risk of RSV, such as infants, older adults, and individuals with certain chronic health conditions.

New Influenza Vaccine Code Update

In another forward-looking update, the AMA introduced a new CPT code for an influenza vaccine derived from cell cultures and adjuvanted, which is designed to address emergent public health needs:

90695: Influenza virus vaccine H5N8, derived from cell cultures, adjuvanted, for intramuscular use

This new code will come into effect following the acquisition of Emergency Use Authorization (EUA) or FDA approval. The introduction of this code reflects the AMA’s proactive approach to preparing for potential flu outbreaks, particularly those involving new and potentially more virulent strains of the virus.

Conclusion: Staying Ahead with the Latest CPT Code Updates

As healthcare continues to evolve rapidly, staying informed about the latest CPT code updates is essential for maintaining an accurate and efficient medical coding and billing process. The updates discussed in this article represent just a few of the changes that will be included in the CPT 2025 manual. Healthcare practitioners and managers should ensure they thoroughly review the official AMA documentation to fully understand and integrate these updates into their workflow. Doing so will not only enhance the accuracy of medical billing but also support the delivery of effective healthcare services.