Are there any new CPT codes that are specific to the monkeypox virus?
Yes. In a Special Edition of the CPT Assistant, the AMA announced the creation of 3 new CPT codes, specific to the monkeypox virus, which per the AMA are effective on July 26, 2022, the same day as their announcement. For your convenience, the long descriptors of the CPT codes are provided below:
- 87593 - Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each
- 90611 - Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use
- 90622 - Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use
CPT code 87593 describes laboratory diagnostic testing for the orthopoxvirus. Because the Monkeypox virus is closely related to the virus that causes smallpox, the smallpox vaccine can protect people from getting monkeypox. Vaccine product code 90611 (brand name JYNNEOS) is for the smallpox and monkeypox combined vaccine. CPT vaccine product code 90622 (brand name ACAM2000) is for the traditional smallpox vaccine. Per the AMA, existing vaccine administration codes (90460, 90461, 90471, 90472) should be utilized with the vaccine product codes.
Readers should be advised that CMS has not yet made any coverage announcements regarding the 3 new codes at this time. We will provide any updates to the status of these codes, payment information and any other pertinent details if and when they are made available by CMS.
Resources:
AMA Announcement
https://www.ama-assn.org/practice-management/cpt/orthopoxvirus-and-monkeypox-coding-guidance
CPT Assistant, July 2022
https://www.ama-assn.org/system/files/cpt-assistant-guide-monkeypox-july-2022.pdf
World Health Organization Monkeypox Fact Sheet
https://www.who.int/news-room/fact-sheets/detail/monkeypox
CDC U.S. Monkeypox Outbreak
https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html
FDA Approval of JYNNEOS
https://www.fda.gov/vaccines-blood-biologics/jynneos
FDA Approval of ACAM2000
https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000