New billing codes for monkeypox testing, vaccines unveiled

Codes enable billing for lab tests, administering vaccines

In another sign of concern over the rapid spread of monkeypox, the American Medical Association (AMA) has developed three new billing codes for testing and vaccinating for the disease.

In a July 26 statement, the AMA said it has added one laboratory testing and two product codes for monkeypox vaccines to the Current Procedural Terminology (CPT) code set, effective immediately. The announcement follows the World Health Organization’s July 23rd declaration of monkeypox as a global health emergency,

“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,” AMA President Jack Resneck Jr., M.D. said in the statement.

The new codes “are designed to clinically distinguish the diagnostic test and vaccinations for monkeypox to support data-driven tracking, reporting and analysis necessary for resource planning and allocation during the public health response to the outbreak,” the statement adds.

According to the Centers for Disease Control and Prevention, as of July 26 there were more than 19,000 confirmed monkeypox/orthopox cases worldwide, including about 3,600 in the U.S. The U.S. recorded its highest daily case count—439—on July 25.

The new vaccine codes are designed for the two available smallpox and monkeypox virus products, the AMA says. Code 90622 describes ACAM2000, an FDA-approved vaccine manufactured by Sanofi Pastuer Biologics Co. for active immunization against smallpox for persons determined to be at high risk for smallpox infection.

Code 90611 describes the FDA-approved JYNNEOS vaccine manufactured by Bavarian Nordic for prevention of smallpox and monkeypox disease in adults 18 years of age and older at high risk for smallpox or monkeypox infection. The new laboratory test CPT code (87593) is for molecular diagnostic testing that detects the nucleic signature of an orthopox virus, including the monkeypox virus.

“The daily increase in cases in the U.S. 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,” Resneck said.