Monkeypox: Disease Breakdown & Diagnosis Code for Monkeypox Virus
Monkeypox is a rare viral disease. The monkeypox virus is from the same family of viruses as smallpox, orthopoxvirus, with similar but less serious symptoms. Unlike smallpox, monkeypox is rarely fatal. Monkeypox and chickenpox, which is a type of herpes virus, are not related viruses.
Monkeypox received its name in 1958 when the disease was found in monkeys used for research. The exact source of the disease is still unknown, but non-human primates such as monkeys and rodents may harbor the virus. It is a zoonotic disease, meaning that it can be transmitted from animals to humans, humans to animals, or from one human to another.
Tracking the 2022 Monkeypox Outbreak
For decades, monkeypox was seen only in Africa. However, monkeypox has recently been found in other countries, including Europe, the Americas, and Australia. International travel has contributed to the virus becoming more common. The year 2022 has brought outbreaks to countries outside of Africa. The CDC is tracking this outbreak.
The CDC website includes a 2022 Monkeypox Outbreak Global Map with case counts for countries that have traditionally reported monkeypox virus cases and those that have not, such as the United Kingdom. A U.S. Map and Case Count, which includes a real-time number of cases by state, is also available. The data are updated Monday-Friday.
Fever is usually the first symptom; others may include headache, swollen lymph nodes, chills, exhaustion, and muscle and backaches. A skin rash that resembles blisters or pimples may develop before or after other symptoms. The rash can appear on the face, inside the mouth, and other body sites such as the hands, feet, chest, or genitals. Monkeypox is transmissible from when symptoms develop until the rash has completely healed. Typically, the illness lasts from two-four weeks.
Person-to-person spread is possible from direct contact with an infected person’s rash, scabs, or bodily fluids. Prolonged face-to-face contact can promote spread via respiratory secretions from an infected person. Contact with items such as bedding or clothes that touched the infectious rash or body fluids can also transmit the virus. It is unknown whether the virus can be spread via semen or vaginal fluids.
Monkeypox is diagnosed by analysis of a tissue sample from an open sore via polymerase chain reaction (PCR) testing. Blood samples may also be taken to diagnose the condition.
Treatment and Vaccination
Specific treatment for monkeypox virus is not available, though antiviral drugs and vaccines developed for smallpox may be used to treat and prevent monkeypox infections. According to the CDC, antivirals such as tecovirimat (TPOXX) may be administered for immunocompromised patients or others who are more likely to experience severe symptoms.
The CDC does not recommend widespread vaccination at this time. However, vaccination may be recommended for people diagnosed with or exposed to monkeypox. This includes those who have been in contact with someone with monkeypox and laboratory workers who perform testing for monkeypox.
The FDA licenses two vaccines for preventing monkeypox infection: JYNNEOS, also known as Imvamune or Imvanex, and ACAM2000. There is currently only a limited supply of JYNNEOS in the US, though more is expected to be available. Supplies of ACAM2000 are available. However, this vaccine should not be used for patients with weakened immune systems, skin conditions such as atopic dermatitis or eczema, or pregnant patients. Data are being collected, but there is no current information on the effectiveness of the vaccines on the current outbreak.
See the CDC website for detailed information on the two vaccines.
ICD-10-CM Code for Monkeypox Virus
Monkeypox is coded in the first chapter of ICD-10-CM, Certain infectious and parasitic diseases, which includes diseases generally recognized as communicable or transmissible. The code is B04, in the code section B00-B09, viral infections characterized by skin and mucous membrane lesions. Note that smallpox, the related orthopoxvirus, is coded as B03.
CPT Codes for Monkeypox Virus Under Development
The AMA has scheduled an expedited meeting of the CPT Editorial Panel to review two separate requests for CPT codes related to monkeypox/orthopox testing and the vaccine product. Information on these potential codes will be relayed on the YES Blog when available.
The CDC website has extensive information about the monkeypox virus. Some subsections of the site have been referenced above. See the main site for more information.
The AMA has an excellent overview of monkeypox presented by Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine.
A Fact Sheet on the United States Response to the Monkeypox Outbreak is available.