The provisional CPT code is effective for use on the condition that H5N8 Influenza virus vaccine candidates receive emergency use authorization from the U.S. Food and Drug Administration (FDA). The AMA is publishing the CPT code update now to ensure electronic systems across the U.S. health care system are prepared in advance for potential FDA authorization.

“The new CPT code is a vital preparatory step in response to the potential danger to humans from a highly infectious avian influenza disease,” said AMA President Bruce A. Scott, M.D. “A CPT code that clinically distinguishes the avian influenza vaccine allows for data-driven tracking, reporting and analysis that supports planning, preparedness, and allocation of vaccines in case a public health response is needed for avian flu prevention.”

For quick reference, the new product code assigned to H5N8 influenza virus vaccines is:

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

The new CPT code for H5N8 influenza virus vaccines should be used with one of the following administration codes to report the work counseling patients or caregivers, administering the vaccine, and updating the medical record.

For children (through 18 years of age) the administration codes are:

90460 Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered

90461 Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered

For adults the administration codes are:

90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)

90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid)

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and into its future.

Questions on CPT coding and content should be directed to the CPT Network.