Measles and Rubella Medical Coding Guide: ICD-10-CM, CPT, and Vaccine Codes

Measles is spreading across the United States, and your facility may already be seeing cases. CDC reported 4,588 confirmed cases as of October 22, 2026, roughly double the 2,289 cases reported in all of 2025. About 96% of 2026 cases are linked to outbreaks. Accurate coding supports patient care, public-health reporting, and clean claims.

Measles vs. Rubella: What Coders Need to Know

Measles (rubeola) and rubella (German measles) are two distinct viral diseases, not two forms of one illness. Each has its own ICD-10-CM category, and the physician’s documentation must say which one is diagnosed. Both are dangerous for unvaccinated children and adults because of potential complications.

How Measles and Rubella Are Diagnosed

A body-covering rash and Koplik spots (tiny white spots inside the mouth) suggest measles but cannot confirm it. Confirmation uses laboratory testing:

• Serology: IgM antibody blood tests for measles or rubella.
• RT-PCR: real-time reverse transcription PCR on a nasopharyngeal swab, throat swab, or urine specimen.

CPT Codes for Measles and Rubella Lab Tests

If your facility performs these tests in-house or you report for a pathology lab:

Verify descriptors against the current AMA CPT code set before billing.

Measles ICD-10-CM Codes (B05)

Measles codes vary by complication. Documentation must link the complication to measles.

These codes show that measles can affect the nervous, respiratory, auditory, digestive, and visual systems. Adults with measles face a higher risk of serious complications.

Rubella ICD-10-CM Codes (B06)

Rubella also causes complications beyond the rash, and the codes follow the same pattern:

Congenital Rubella Syndrome: Use P35.0, Not B06

Category B06 carries an Excludes1 note. When congenital rubella syndrome (CRS) is documented, report P35.0. CRS occurs when a pregnant woman passes rubella to her fetus. It can cause congenital cataracts, heart disease, hearing loss, and intellectual disability. The US declared rubella eliminated in 2004, but imported cases still occur, so CRS remains a reporting possibility.

Treatment Documentation: What to Look For

No specific antiviral treatment exists for measles or rubella. Standard care is supportive: rest, fluids, and fever management. CDC guidance also addresses vitamin A for measles in children, so check the clinical overview linked below. Clinicians watch for complications such as pneumonia, and those complications drive code selection. Capture them in the record.

MMR Vaccine Coding: Administration and Product Codes

Every vaccination needs two codes: one for administration and one for the vaccine product.

Step 1: Choose the product code

Check the documentation to confirm which product was given.

Step 2: Choose the administration code

You will often add Z23 (encounter for immunization). Payer rules vary, so confirm with your payer policies.

Schedule: CDC recommends two MMR doses, the first at 12–15 months and the second at 4–6 years. MMR can be given subcutaneously or intramuscularly.

5 Coding Tips for Measles and Rubella Encounters

1. Confirm the virus. Measles and rubella have different code categories.
2. Capture the clinical picture. Look for rash pattern and whether Koplik spots were documented.
3. Match orders to results. Check the EHR for serology, PCR, or urine orders and the pathology report.
4. Code complications precisely. Query the provider if a complication is implied but not stated.
5. Check for vaccine documentation, including product, route, and counseling.

Frequently Asked Questions

What is the ICD-10 code for measles?
Measles is coded in category B05. Uncomplicated measles is B05.9. Complications change the code, for example B05.2 for pneumonia and B05.0 for encephalitis.

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What is the ICD-10 code for rubella?
Rubella is coded in category B06. Uncomplicated rubella is B06.9.

What is the CPT code for the MMR vaccine?
90707 is the MMR vaccine product code. Pair it with an administration code such as 90460 or 90471, depending on patient age and counseling documentation.

What is the CPT code for MMRV?
90710 reports the MMRV vaccine, which adds varicella protection.

Which code is used for congenital rubella syndrome?
P35.0. Category B06 has an Excludes1 note for CRS.

How many measles cases has the US reported in 2026?
CDC-based reports show 4,588 confirmed cases as of October 22, 2026. Check CDC’s page for the latest weekly count.

References

1. Centers for Disease Control and Prevention. Measles Cases and Outbreaks. https://www.cdc.gov/measles/data-research/index.html
2. ContagionLive. Measles Update: October 23, 2026. https://www.contagionlive.com/view/measles-update-october-23-2026
3. CDC. Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome, United States, 1969–2004. MMWR 2005;54(11). https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a5.htm
4. CDC. Three Cases of Congenital Rubella Syndrome in the Postelimination Era: Maryland, Alabama, and Illinois, 2012. MMWR, March 29, 2013. https://stacks.cdc.gov/view/cdc/54430/Email
5. CDC. Measles: Clinical Overview for Healthcare Providers. https://www.cdc.gov/measles/hcp/clinical-overview/index.html
6. CDC. Child and Adolescent Immunization Schedule. https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html
7. CMS. ICD-10-CM Official Code Set (FY 2027). https://www.cms.gov/medicare/coding-billing/icd-10-codes
8. American Medical Association. CPT Code Set (current edition). https://www.ama-assn.org/practice-management/cpt