DHCS advises physicians to hold Medi-Cal claims for monkeypox tests

August 09, 2022

The California Department of Health Care Services (DHCS) released guidance regarding a new CPT code created to streamline the reporting of orthopoxvirus (e.g., monkeypox) testing (87593). As soon as DHCS has updated its systems, physicians will be able to bill CPT code 87593 as a Medi-Cal benefit. Until then, physicians are advised to administer the test as needed, but to hold the claim for submission.

Additionally, the American Medical Association has also created two new CPT codes for monkeypox vaccines. The new monkeypox CPT codes are:

  • 87593: Infectious agent detection by nucleic acid [DNA or RNA]; orthopoxvirus [e.g., monkeypox virus, cowpox virus, vaccinia virus], amplified probe technique, each
  • 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 

For additional information on monkeypox symptoms, testing, treatment and vaccination, view the California Department of Public Health and the Centers for Disease Control and Prevention websites.


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