Also known as shingles, herpes zoster is a viral infection caused by the varicella-zoster virus (VZV). VZV is the same virus that causes chickenpox. According to CDC, an estimated one million cases of herpes zoster occur annually in the United States and the incidence for this infection is approximately 4 cases per 1,000 U.S. population annually. Dermatologists treating herpes zoster can partner with an experienced medical coding company to report the diagnosis, treatments and prevention vaccinations for herpes zoster on their medical claims, and assign accurate medical codes. People with conditions such as cancer, human immunodeficiency virus (HIV), or those taking immunosuppressive medications that could compromise or suppress their immune system are at increased risk for herpes zoster. Though the initial signs are a tingling feeling on the skin, itchiness, or a stabbing pain, major symptoms include painful, itchy, or tingly rashes and long-lasting nerve pain. Though the skin rash resembles a chickenpox rash, it affects only certain areas. Treatment for shingles includes antiviral medications such as acyclovir, famciclovir, or valacyclovir that help to reduce the amount of time having a shingles rash, decreasing the severity of the rash and reducing the risk of developing long-lasting nerve pain and other health problems.
Are Herpes Zoster and Varicella the Same?
Even though shingles and varicella (chickenpox) are caused by the same virus, they are not the same illness. Chickenpox is a milder illness that affects children and adults and the virus stays in the body even after recovery. Shingles results from a reactivation of the virus long after the chickenpox illness has disappeared
ICD-10 Codes for Herpes Zoster
- B02 Zoster [herpes zoster]
- B02.0 Zoster encephalitis
- B02.1 Zoster meningitis
- B02.2 Zoster with other nervous system involvement
- B02.21 Postherpetic geniculate ganglionitis
- B02.22 Postherpetic trigeminal neuralgia
- B02.23 Postherpetic polyneuropathy
- B02.24 Postherpetic myelitis
- B02.29 Other postherpetic nervous system involvement
- B02.3 Zoster ocular disease
- B02.30 …… unspecified
- B02.31 Zoster conjunctivitis
- B02.32 Zoster iridocyclitis
- B02.33 Zoster keratitis
- B02.34 Zoster scleritis
- B02.39 Other herpes zoster eye disease
- B02.7 Disseminated zoster
- B02.8 Zoster with other complications
- B02.9 Zoster without complications
Recombinant zoster vaccine (RZV, Shingrix) is the recommended vaccine for adults 50 years and older, to prevent shingles and its complications. CDC reports that protection from this FDA-approved vaccine stays above 85% for at least the first four years after vaccination.
- CPT 90750 – Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.
Recommended ICD-10 code for vaccine administration is
- Z23 Encounter for Immunization
However, Shingrix is not indicated for prevention of primary varicella infection (chickenpox). The recommended dosage of Shingrix is two doses (0.5 mL each). Medicare Part D generally covers the shingles vaccine. Commercial policies such as Anthem, UnitedHealthcare, and Aetna that are compliant with the Affordable Care Act (ACA) preventive coverage will pay for this vaccine, based on the recommendation of the Advisory Committee on Immunization Practices (ACIP). Zostavax® (licensed 2006) is another licensed vaccine available in the U.S to prevent herpes zoster. is. An experienced dermatology medical billing company can assist dermatologists in documenting this condition as well as any treatments provided, ensuring clean medical claims with the correct medical codes.
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