Outbreak of Yellow Fever Reported

Consider your health in your travel plans.

The Pan American Health Organization (PAHO), which is in Washington D.C., is reminding travelers to get vaccinated if you are planning a trip to areas in which yellow fever is present. Which countries are affected by yellow fever? In the Americas, the countries are Bolivia, Brazil, Columbia, Ecuador, French Guiana, Suriname, and Peru. In 2019, Brazil and Peru have reported confirmed cases of yellow fever. The Centers for Disease Control & Prevention (CDC) has identified 44 countries that have a yellow fever risk.

Vaccinations must be received at least 10 to 14 days prior to visiting these countries.   

You may wonder why vaccination is important. This is why:

Yellow fever is an acute viral hemorrhagic fever. It is transmitted by mosquitos. This condition can result in death. 

Yellow fever is easily prevented by vaccination. The symptoms of the condition are the yellowing of the skin and fever, hence the name. The disease can cause liver damage such as hepatitis.

There are three stages to yellow fever. Headache, muscle and joint aches, fever, anorexia, vomiting, and jaundice are experienced by the patient in the first stage. These symptoms will develop in the first three to six days. This time period is when the infection occurs. In the second stage, the patient may feel like they have recovered, as their symptoms may lessen. This stage is also known as remission. In the third stage, organ dysfunction may occur (heart, liver, or kidneys). Internal bleeding or hemorrhage occurs in the most severe stage of the disease. Fifty percent of the patients that survive until the third stage expire. The third stage is known as intoxication.

This condition is diagnosed through blood tests, which will also show the extent of liver and/or kidney failure. Shock can be diagnosed as well by the laboratory tests.

There is no cure for this condition. Once a patient has contracted yellow fever, only the symptoms can be treated. The treatment for the patient’s symptoms may include blood products, dialysis, and intravenous fluids. Inpatient care is often needed for treatment.

From a coding perspective, yellow fever is found in the Index under Fever, yellow. The Index entry also provides for further specific options of jungle (A95.0); sylvatic (A95.0); and urban (A95.1). The non-specific condition is coded as A95.9 and is considered an unspecified code. There are no specific guidelines that apply to yellow fever. If the patient would develop sepsis or severe sepsis as a result, then the guidelines for sepsis would apply.

Yellow fever is found in the arthropod-borne viral fevers and viral hemorrhagic fevers section (A90 – A99). There are no additional coding instructions with this section.

If you are visiting your physician for the vaccination, the diagnosis code assignment is Z23. The vaccine administration and vaccine will be captured with the CPT codes. In addition to vaccination, you can use mosquito nets (when sleeping), apply mosquito repellants, and wear clothing that covers all skin.

Plan early and consider your health as you are making plans for your next vacation!

Program Note:

Listen to Laurie Johnson report this story live today on Talk Ten Tuesday, 10-10:30 a.m. EST.


Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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