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ICD-10 Guide
ICD-10 CodesB08.011

B08.011

Vaccinia not from vaccine

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 B08.011 is a billable code used to indicate a diagnosis of vaccinia not from vaccine.

Key Diagnostic Point:

Vaccinia not from vaccine refers to an infection caused by the vaccinia virus, which is a member of the Orthopoxvirus genus. This condition occurs when an individual is infected with the vaccinia virus through exposure to infected animals or contaminated materials, rather than through vaccination. Symptoms may include fever, malaise, and the development of a rash that can progress to vesicular lesions similar to those seen in smallpox. The condition is rare in the general population but can occur in individuals who work with animals or in laboratory settings. Vaccinia infections can lead to complications such as secondary bacterial infections, eczema vaccinatum in individuals with a history of eczema, and in rare cases, encephalitis. Diagnosis is typically made through clinical evaluation and may be confirmed with laboratory testing. Treatment is generally supportive, focusing on symptom management and preventing secondary infections. Understanding the transmission routes and clinical manifestations of vaccinia not from vaccine is crucial for healthcare providers to ensure appropriate management and prevent outbreaks.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from vaccine-related vaccinia
  • Potential for severe complications in immunocompromised patients
  • Need for accurate exposure history documentation
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of exposure history
  • Misclassification as vaccine-related vaccinia
  • Failure to document complications
  • Lack of laboratory confirmation

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, including exposure sources and vaccination status.

Common Clinical Scenarios

Patients presenting with vesicular lesions and fever after exposure to animals or contaminated materials.

Billing Considerations

Consideration of patient’s immunocompromised status and potential complications.

Dermatology

Documentation Requirements

Photographic evidence of lesions and detailed descriptions of rash progression.

Common Clinical Scenarios

Patients with skin lesions resembling vaccinia who may have a history of eczema.

Billing Considerations

Differentiating from other dermatological conditions and documenting any secondary infections.

Coding Guidelines

Inclusion Criteria

Use B08.011 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the source of infection and any complications
  • related

Exclusion Criteria

Do NOT use B08.011 When
  • Exclude cases where the infection is clearly vaccine

Related CPT Codes

87593CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); direct probe technique

Clinical Scenario

Used when laboratory confirmation of vaccinia is required.

Documentation Requirements

Document the reason for testing and any clinical findings.

Specialty Considerations

Infectious disease specialists may require additional details on exposure history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of vaccinia infections, improving the ability to track and manage cases effectively. It has also highlighted the need for thorough documentation to differentiate between vaccine-related and non-vaccine-related cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of vaccinia infections, improving the ability to track and manage cases effectively. It has also highlighted the need for thorough documentation to differentiate between vaccine-related and non-vaccine-related cases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of vaccinia infections, improving the ability to track and manage cases effectively. It has also highlighted the need for thorough documentation to differentiate between vaccine-related and non-vaccine-related cases.

Resources

Clinical References

  • •
    CDC Vaccinia Information

Coding & Billing References

  • •
    CDC Vaccinia Information

Frequently Asked Questions

What is the primary cause of vaccinia not from vaccine?

Vaccinia not from vaccine is primarily caused by exposure to the vaccinia virus through contact with infected animals or contaminated materials, rather than through vaccination.