Reimbursement News

AMA Announces CPT Code Update for Monkeypox Vaccines, Testing

The CPT code update includes codes for diagnostic testing, a smallpox vaccine, and a monkeypox vaccine.

CPT code update, monkeypox vaccine, current procedural terminology

Source: AMA Logo

By Victoria Bailey

- The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a laboratory test CPT code for the orthopoxvirus and two CPT codes for the monkeypox vaccines.

The CPT codes are effective for immediate use and will allow healthcare providers to distinguish between the diagnostic test and vaccinations for monkeypox. This can help support data tracking, reporting, and analysis used to allocate resources during the public health response to the monkeypox outbreak.

The update comes just a few days after the World Health Organization (WHO) declared monkeypox a public health crisis.

“In the wake of the World Health Organization declaring monkeypox a global health emergency, and with case numbers increasing in the United States, these CPT updates are timely,” Jack Resneck Jr., MD, president of AMA, said in the press release. “The daily increase in cases in the US shows community spread occurring; however, we are relieved to see access to testing has increased to 80,000 specimens per week with commercial labs now online and vaccine supply is increasing.”

The laboratory test CPT code is as follows:

87593     Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each

This code describes the molecular diagnostic testing that detects the nucleic signature of an orthopoxvirus, including the monkeypox virus.

The product codes for the vaccines are as follows:

90622    Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use

90611     Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use

The first code describes the FDA-approved ACAM2000 vaccine manufactured by Sanofi for active immunization against smallpox diseases for people determined to be at high risk for smallpox infection.

The second code is for the FDA-approved JYNNEOS vaccine manufactured by Bavarian Nordic to prevent smallpox and monkeypox disease in adults 18 years and older at high risk for smallpox or monkeypox infection.

Short, medium, and long descriptors for the new CPT codes can be found on the AMA website.

CPT code set changes are determined by the CPT Editorial Panel through an open editorial process. The panel collects input from healthcare stakeholders to ensure CPT codes reflect modern coding demands.