CPT® Code 90611

Official Description

Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use

Common Language Description

The CPT® Code 90611 refers to a specific vaccine designed to provide active, long-term immunity against smallpox and monkeypox. This vaccine utilizes an attenuated form of the vaccinia virus, which is a live but non-replicating virus. The term "attenuated" indicates that the virus has been altered in such a way that it cannot cause disease in the recipient, yet it is still capable of stimulating the immune system to produce antibodies. The vaccine is preservative-free and is administered in a dosage of 0.5 mL as a suspension intended for subcutaneous use. Smallpox and monkeypox are both classified as orthopoxviruses, which are large, enveloped, double-stranded DNA viruses that primarily infect epidermal cells. Infection with these viruses can lead to characteristic pock lesions and systemic symptoms due to viremia, as the virus disseminates through the lymphatic system. While monkeypox typically presents with milder symptoms compared to smallpox, both diseases have the potential to be fatal. The vaccine's formulation allows for cross-protection against these orthopoxviruses, making it particularly important for adults who are at high risk of exposure. It is important to note that this code specifically reports the vaccine product itself and does not encompass the administration of the vaccine, which is a separate procedure.

1. Indications

The smallpox and monkeypox vaccine (CPT® Code 90611) is indicated for individuals who are at high risk of exposure to the orthopoxviruses, specifically smallpox and monkeypox. The following conditions and situations warrant the administration of this vaccine:

High-Risk Exposure: Individuals who may be exposed to smallpox or monkeypox due to occupational hazards, such as healthcare workers or laboratory personnel handling these viruses.
Travel to Endemic Areas: Persons planning to travel to regions where monkeypox is endemic or where there is a potential outbreak of smallpox.
Public Health Response: Individuals involved in public health initiatives or emergency response efforts during outbreaks of smallpox or monkeypox.

2. Procedure

The administration of the smallpox and monkeypox vaccine involves several key procedural steps to ensure proper delivery and effectiveness of the vaccine:

Preparation of the Vaccine: The vaccine is prepared by ensuring that it is in a suitable suspension form, free from preservatives, and ready for subcutaneous administration. This involves checking the expiration date and ensuring that the vaccine is stored at the appropriate temperature prior to use.
Site Selection: The healthcare provider selects an appropriate site for subcutaneous injection, typically the outer aspect of the upper arm, where there is adequate subcutaneous tissue.
Administration: The vaccine is administered via subcutaneous injection, delivering the 0.5 mL dosage of the attenuated vaccinia virus. The injection technique should minimize discomfort and ensure that the vaccine is deposited in the subcutaneous tissue.
Post-Administration Monitoring: After the vaccine is administered, the recipient is monitored for a short period to observe for any immediate adverse reactions or side effects, ensuring that they are stable before leaving the healthcare setting.

3. Post-Procedure

Following the administration of the smallpox and monkeypox vaccine, recipients should be informed about potential side effects, which may include mild local reactions such as redness, swelling, or tenderness at the injection site. It is important for individuals to be aware of these reactions and to report any unusual symptoms to their healthcare provider. Recipients should also be advised on the importance of follow-up appointments, if necessary, to monitor their immune response and to receive any additional vaccinations or boosters as recommended. Overall, the expected recovery period is typically short, with most individuals resuming normal activities shortly after vaccination.

Short Descr	SMALLPOX&MONKEYPOX VAC 0.5ML
Medium Descr	SMALLPOX&MONKEYPOX VACC 0.5ML DOS FOR SUBQ USE
Long Descr	Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	none
MUE	1

GA	Waiver of liability statement issued as required by payer policy, individual case
GC	This service has been performed in part by a resident under the direction of a teaching physician
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
JG	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
JZ	Zero drug amount discarded/not administered to any patient
SL	State supplied vaccine