For reimbursement claims, medical providers are required to use ICD-10-CM codes. According to the Centers for Disease Control and Prevention, treatment for Lyme disease after diagnosis requires an initial four-week course of antibiotic therapy in the event the disease persists after the initial four weeks of using oral antibiotics or in case of Lyme carditis where cardiovascular complications are experienced as well as in case of neurological complications. Most of the insurance carriers use the ICD-10-CM code as a guideline to seek compensation for the treatment received. However, this becomes difficult patients are subjected to continuing Lyme symptoms beyond the stipulated four weeks of initial treatment. Instead, CDC recognizes post-treatment Lyme disease syndrome in case of chronic Lyme disease which may cause severe tissue and immune system damages.
Since post-treatment Lyme disease syndrome currently has no ICD-10-CM code, Lyme disease is classified as a subcategory with additional subdivisions in the ICD-10-CM manual. The subdivision codes are thus the ones used to accurately describe a patient’s symptoms which will be used in billing.
The ICD-10-CM code for Lyme disease is A 69.2 covering Erythema chronicum migrans due to the bacterial infection.
Here are the ICD-10 codes for Lyme disease and its post-treatment Lyme disease syndrome:
- A 69.20 – Lyme disease, unspecified Erythema chronicum migrans
- A 69.21 – Meningitis symptoms due to Lyme disease
- A 69.22 – Neurological disorders due to Lyme disease like Polyneuropathy, Cranial neuritis, Meningoencephalitis
- A 69.23 – Arthritis due to Lyme disease
- A 69.29 – Other conditions associated with LD including Myopericarditis caused by LD
- A 69.8 – Other specified spirochetal infections
- A 69.9 – Spirochetal infection, unspecified
References:
https://www.icd10data.com/ICD10CM/Codes/A00-B99/A65-A69/A69-/A69.20
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