ICD-10-CM Code For Monkeypox: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group B04 includes diagnoses for monkeypox virus infection, covering acute viral illness with characteristic skin and mucosal lesions, and associated systemic manifestations. These ICD-10-CM diagnosis codes are used to document clinical scenarios such as primary infection, exposure-related illness, and disease manifestations that capture severity, presence of complications, or organ involvement. Accurate coding within the ICD-10-CM B04 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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ICD-10-CM B04: Monkeypox Overview

The ICD-10-CM B04 group represents monkeypox virus infections, which are viral illnesses primarily characterized by skin and mucous membrane lesions and systemic symptoms. These diagnoses target the integumentary and infectious disease processes caused by the orthopoxvirus. Accurate coding matters for appropriate claim processing and to reflect the clinical severity and resource use associated with care.

When to Use

Use a code from this group when a clinical diagnosis of monkeypox infection is established or when coding encounters for confirmed infection and its complications. These codes are appropriate for documenting visits related to diagnosis, treatment, and management of monkeypox and its associated clinical manifestations.

ICD-10-CM Codes

1 rows

ICD-10-CM Code	Description
B04	Monkeypox

DRG Codes

2 rows

DRG Code	Description
865	Viral Illness with MCC
866	Viral Illness without MCC

Typical Clinical Scenarios

An adult presents to the emergency department with sudden onset fever, severe malaise, and a painful vesiculopustular rash concentrated on the face, palms, and soles after recent travel and known close contact with a confirmed case. Physical exam shows umbilicated lesions at multiple stages of evolution and tender regional lymphadenopathy prompting isolation and laboratory testing for orthopoxvirus. A diagnosis from this group is assigned to capture the acute viral illness with characteristic skin and mucous membrane lesions. Typical codes: B04
A young child is brought to primary care with a progressive eruption of painful, crusting skin lesions around the mouth and perianal region over several days, accompanied by low-grade fever and sore throat; the clinician documents recent exposure at a community gathering. Because the presentation is an active cutaneous viral infection consistent with the described syndrome and requires infection-control counseling and symptomatic treatment, the encounter is coded from this group. Typical codes: B04
An immunocompromised adult with HIV presents for inpatient evaluation after developing extensive mucocutaneous lesions, secondary bacterial superinfection of skin lesions, and systemic symptoms requiring hospitalization and IV antibiotics. The primary diagnosis from this group is used to indicate the underlying viral etiology contributing to the severe course and complications during this admission. Typical codes: B04

ICD-10-CM Code For Herpesviral Herpes Simplex Infections: Group Overview

B01-VARICELLA-CHICKENPOX

ICD-10-CM Code For Varicella Chickenpox: Group Overview

B02-ZOSTER-HERPES-ZOSTER

ICD-10-CM Code For Zoster Herpes Zoster: Group Overview

B03-SMALLPOX

ICD-10-CM Code For Smallpox: Group Overview

B05-MEASLES

ICD-10-CM Code For Measles: Group Overview

B06-RUBELLA-GERMAN-MEASLES

ICD-10-CM Code For Rubella German Measles: Group Overview

B07-VIRAL-WARTS

ICD-10-CM Code For Viral Warts: Group Overview

B08-OTHER-VIRAL-SKIN-AND-MUCOUS-LESIONS

ICD-10-CM Code For Other Viral Infections Characterized By Skin And Mucous Membrane Lesions: Group Overview

B09-UNSPECIFIED-VIRAL-MUCOCUTANEOUS-LESIONS

ICD-10-CM Code For Unspecified Viral Infection Characterized By Skin And Mucous Membrane Lesions: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

1 rows

ICD-10-CM Code	Description
B04	Monkeypox

DRG Codes

2 rows

DRG Code	Description
865	Viral Illness with MCC
866	Viral Illness without MCC

Typical Clinical Scenarios

An adult presents to the emergency department with sudden onset fever, severe malaise, and a painful vesiculopustular rash concentrated on the face, palms, and soles after recent travel and known close contact with a confirmed case. Physical exam shows umbilicated lesions at multiple stages of evolution and tender regional lymphadenopathy prompting isolation and laboratory testing for orthopoxvirus. A diagnosis from this group is assigned to capture the acute viral illness with characteristic skin and mucous membrane lesions. Typical codes: B04
A young child is brought to primary care with a progressive eruption of painful, crusting skin lesions around the mouth and perianal region over several days, accompanied by low-grade fever and sore throat; the clinician documents recent exposure at a community gathering. Because the presentation is an active cutaneous viral infection consistent with the described syndrome and requires infection-control counseling and symptomatic treatment, the encounter is coded from this group. Typical codes: B04
An immunocompromised adult with HIV presents for inpatient evaluation after developing extensive mucocutaneous lesions, secondary bacterial superinfection of skin lesions, and systemic symptoms requiring hospitalization and IV antibiotics. The primary diagnosis from this group is used to indicate the underlying viral etiology contributing to the severe course and complications during this admission. Typical codes: B04

ICD-10-CM Code For Herpesviral Herpes Simplex Infections: Group Overview

B01-VARICELLA-CHICKENPOX

ICD-10-CM Code For Varicella Chickenpox: Group Overview

B02-ZOSTER-HERPES-ZOSTER

ICD-10-CM Code For Zoster Herpes Zoster: Group Overview

B03-SMALLPOX

ICD-10-CM Code For Smallpox: Group Overview

B05-MEASLES

ICD-10-CM Code For Measles: Group Overview

B06-RUBELLA-GERMAN-MEASLES

ICD-10-CM Code For Rubella German Measles: Group Overview

B07-VIRAL-WARTS

ICD-10-CM Code For Viral Warts: Group Overview

B08-OTHER-VIRAL-SKIN-AND-MUCOUS-LESIONS

ICD-10-CM Code For Other Viral Infections Characterized By Skin And Mucous Membrane Lesions: Group Overview

B09-UNSPECIFIED-VIRAL-MUCOCUTANEOUS-LESIONS

ICD-10-CM Code For Unspecified Viral Infection Characterized By Skin And Mucous Membrane Lesions: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Monkeypox: Group Overview

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ICD-10-CM B04: Monkeypox Overview

ICD-10-CM Code For Monkeypox: Group Overview

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ICD-10-CM B04: Monkeypox Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

ICD-10-CM Code For Monkeypox: Group Overview

Sign up for ICD-10-CM Code For Monkeypox: Group Overview policy alerts

ICD-10-CM B04: Monkeypox Overview

ICD-10-CM Code For Monkeypox: Group Overview

Sign up for ICD-10-CM Code For Monkeypox: Group Overview policy alerts

ICD-10-CM B04: Monkeypox Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What does the ICD-10-CM group `B04` represent?

When should `B04` codes be used in documentation and billing?

How does coding `B04` affect claim adjudication and reimbursement?

Which DRGs are related to the `B04` monkeypox code group?

What clinical scenarios are captured by the `B04` diagnosis codes?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What does the ICD-10-CM group `B04` represent?

When should `B04` codes be used in documentation and billing?

How does coding `B04` affect claim adjudication and reimbursement?

Which DRGs are related to the `B04` monkeypox code group?

What clinical scenarios are captured by the `B04` diagnosis codes?

References