CPT Update for Monkeypox Testing and Vaccination

The American Medical Association (AMA) (@AmerMedicalAssn) announced an update to Current Procedural Terminology (CPT)®, the nation’s leading medical terminology code set for describing health care procedures and services, that includes a new laboratory test code for the orthopoxvirus and two codes for the vaccines being utilized to prevent monkeypox infection.

These new CPT codes are effective for immediate use and 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.

“In the wake of the World Health Organization (W.H.O.) declaring monkeypox a global health emergency, and with case numbers increasing in the United States, these CPT updates are timely,” said AMA President Jack Resneck Jr., M.D. “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. Monkeypox is most often spread person to person through close personal contact, but preventive measures can help you avoid infection. We urge patients to check trusted, evidence-based sources like the CDC and AMA and to contact their physician if they have questions about prevention, diagnosis, or treatment of monkeypox.”

The new laboratory test CPT code (87593) describes molecular diagnostic testing that detects the nucleic signature of an orthopoxvirus, including the monkeypox virus.

The two new vaccine codes are designed to describe the two smallpox and monkeypox virus products currently available. The first code (90622) describes the existing FDA-approved ACAM2000 vaccine manufactured by Sanofi Pastuer Biologics Co. for active immunization against smallpox disease for persons determined to be at high risk for smallpox infection. The second 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.

Short, medium and long descriptors for new CPT codes can be accessed on the AMA website, but for quick reference, the new CPT update includes the following codes and descriptors:

Laboratory test code

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

Product code

• 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

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 the 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 the code to its future.

Questions on CPT coding and content should be directed to the CPT Network, the authoritative source for CPT coding answers.

About the American Medical Association
The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.