Monkey pox

[Nicolle1113]

What are the billing requirements for a laboratory to bill an insurance payer for monkey pox pcr testing? Medical necessity (dx codes)? What is the reimbursement rate/fee schedule (unable to locate on medicare/medi-cal?

 

[TThivierge]

Hi Nicolle1113,
I know the vaccine CPT codes are 90611 & 90622 link with dx Z23. But if lab test is positive for Monkeypox use dx B04 as first dx code. If the doctor suspects this Monkeypox skin disease he may add A63.8 L98.8 B20, Z21 or B08.09 ending dx Z13.89 or Z11.3. or depending on his or her notations for why doing lab test. The reimbursement fee check under Medicare CMS website
I hope this data helped you
Lady T

 

[braunc135]

Hi Nicolle1113,
I know the vaccine CPT codes are 90611 & 90622 link with dx Z23. But if lab test is positive for Monkeypox use dx B04 as first dx code. If the doctor suspects this Monkeypox skin disease he may add A63.8 L98.8 B20, Z21 or B08.09 ending dx Z13.89 or Z11.3. or depending on his or her notations for why doing lab test. The reimbursement fee check under Medicare CMS website
I hope this data helped you
Lady T

Hello: I don't see that CPT 90611 or 90622 have been added to the CMS Fee Schedule yet, am I missing something?
Christine B

 

[dtuszynski]

Hello: I don't see that CPT 90611 or 90622 have been added to the CMS Fee Schedule yet, am I missing something?
Christine B

this vaccine is currently free so there is no reimbursement.