Medicaid

For commercially acquired product, (not vaccine for children product), Medicaid health care providers should code for the vaccine product administered and the related COVID-19 vaccine administration.

Check with your state agency or Medicaid managed care entity to determine any specific coverage or coding requirements.

Based on your inputs:

mNEXSPIKE
Medicaid
Medical benefit

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CPT Code - Vaccine Product

Use the CPT code for the vaccine and dose administered.

mNEXSPIKE (COVID-19 Vaccine, mRNA 10mcg/0.2mL)

VACCINE CODE:

CPT 91323

VACCINE DESCRIPTOR:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular use

CPT Code - Administration

Use CPT code 90480 for administration of all COVID-19 vaccinations.

ADMINISTRATION CODE:

CPT 90480

ADMINISTRATION DESCRIPTOR:

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, single dose.

Additional Codes

ICD-10

DIAGNOSIS CODE:

Z23 Encounter for Immunization

DIAGNOSIS DOCUMENTATION:

Document the patient's situation and use consistent with the FDA authorization and CDC guidelines as appropriate.

For more details, visit our Frequently Asked Questions page.

Please see the mNEXSPIKE® Full Prescribing Information.

mNEXSPIKE® Full Prescribing Information

The coding and billing information contained in this digital tool is provided as a resource and every effort is made to ensure the accuracy of this information. Appropriate coding and billing for healthcare services are the provider's responsibility and should always be based on the patient's clinical condition, services provided, and current payer guidelines.