Monkeypox – Global Health Emergency - Make Your Revenue Smarter

The World Health Organization (WHO) recently declared monkeypox to be a global health emergency. Director-General Dr Tedros Adhanom Ghebreyesus explained in a press conference July 23, 2022.

Visit the WHO site for the latest reports.

As mentioned in the “Insider’s” portion of Coffee with the Coder® Episode 148, experts are seeking a more appropriate name than monkeypox, because this implies a link to monkeys, or perhaps to Africa. Instead, the disease was initially named because it was first identified in 1958 in a colony of monkeys. The lesions resembled small pox, and was called monkeypox.

The CDC also maintains a webpage with information.

On 9/1/22, CMS issued this

CORRECTION: Monkeypox & Smallpox Vaccines: Include Product Code on Claims

Our August 11 edition told you to only bill for vaccine administration when you got the vaccine at no cost from the government. The correct instructions are to include these 3 elements on your claim, even if you get the vaccine from the government for free:

  1. product code (90611 or 90622)
  2. applicable ICD-10-CM diagnosis code
  3. administration code

We’ll address the no cost government vaccine product payment adjustments during claims processing. You’ll see it on your remittance advice.

Code 90611 for smallpox and monkeypox vaccine product:

  • Long descriptor: Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use
  • Short descriptor: SMALLPOX&MONKEYPOX VAC 0.5ML

Code 90622 for vaccinia (smallpox) virus vaccine product:

  • Long descriptor: Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use
  • Short descriptor: VACCINIA VRS VAC 0.3 ML PERQ

Patient cost sharing applies. Your Medicare Administrative Contractor will give you more information soon about coverage and billing.

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