Facebook tracking pixel
A69.20
ICD-10-CM
Lyme Disease

Find information on Lyme disease diagnosis including clinical manifestations, ICD-10 codes (A69.20, A69.21, A69.22, A69.23, G73.01), differential diagnosis, and best practices for healthcare documentation. Learn about the two-tiered serologic testing process for Lyme disease diagnosis recommended by the CDC, including ELISA and Western blot. This resource provides guidance for clinicians on accurate Lyme disease diagnosis, laboratory testing, and appropriate medical coding for insurance reimbursement. Explore symptoms, treatment options, and long-term health management strategies for Lyme disease.

Also known as

Lyme Borreliosis
Tick-borne Borreliosis

Diagnosis Snapshot

Key Facts
  • Definition : Tick-borne illness caused by Borrelia bacteria.
  • Clinical Signs : Early: Rash, fever, fatigue. Late: Joint pain, neurological issues.
  • Common Settings : Outdoors, wooded areas, grassy fields; primary care clinics, rheumatology.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is Lyme disease confirmed?

  • Yes

    Is there neurologic involvement?

  • No

    Is it early localized stage?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Lyme disease
Southern tick-associated rash illness
Babesiosis

Documentation Best Practices

Documentation Checklist
  • Lyme disease diagnosis documentation checklist
  • ICD-10 code A69.2 (Lyme disease)
  • Document exposure risk (tick bite, geographic area)
  • Symptom documentation (erythema migrans, fatigue, fever)
  • Serologic testing results (ELISA, Western blot) documented
  • Differential diagnosis considerations documented

Coding and Audit Risks

Common Risks
  • Unspecified Lyme Dx Code

    Using unspecified Lyme disease codes (A69.20, A69.29) when clinical documentation supports a more specific diagnosis (e.g., early Lyme A69.21) leads to inaccurate severity reflection and reimbursement.

  • Late Lyme Dx Zapping

    Failing to code late manifestations of Lyme disease (e.g., arthritis M01.41, neurological G93.81) separately, in addition to the Lyme diagnosis code, underrepresents disease burden for quality reporting and resource allocation.

  • Post-Treatment Lyme Coding

    Incorrectly assigning active Lyme disease codes after successful treatment. Post-treatment symptoms should be coded based on the specific manifestation (e.g., fatigue R53.83) not residual Lyme.

Mitigation Tips

Best Practices
  • Document erythema migrans rash details for accurate ICD-10-CM A69.20 code.
  • Improve Lyme disease CDI with standardized symptom & tick exposure queries.
  • Ensure compliance with Lyme testing guidelines for proper CPT coding (86617).
  • For late Lyme, clearly document stage & manifestations for ICD-10-CM code specificity.
  • Timely documentation of neurologic Lyme symptoms supports G04.82 code assignment.

Clinical Decision Support

Checklist
  • Verify exposure risk: recent tick bite, endemic area
  • Assess symptoms: erythema migrans, fever, fatigue, etc.
  • Order two-tier serologic testing: ELISA, then Western blot if positive
  • Document differential diagnoses considered and ruled out
  • Review patient history for contraindications to treatment

Reimbursement and Quality Metrics

Impact Summary
  • Lyme disease reimbursement hinges on accurate ICD-10 codes (A69.2*), CPT codes for testing (86617*) impacting hospital revenue cycle.
  • Miscoded Lyme tests or treatment lead to claim denials, lowered reimbursement rates, impacting hospital financial performance.
  • Prompt Lyme diagnosis and treatment using correct codes improves patient outcomes, reduces complications, and enhances quality metrics.
  • Accurate Lyme disease reporting impacts public health surveillance data, influencing resource allocation and prevention strategies.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code confirmed Lyme A69.20
  • Early Lyme? Use A69.2X
  • Neuro Lyme? G04.82
  • Lyme arthritis? M01.4*
  • Document exposure details

Documentation Templates

Patient presents with suspected Lyme disease.  Symptoms onset was approximately [number] weeks ago following a reported tick bite in [location] on [date].  Patient exhibits [mention specific symptoms e.g., erythema migrans characterized by a [description of rash e.g., bullseye rash expanding over time], fatigue, headache, myalgia, arthralgia].  Differential diagnosis includes viral infection, fibromyalgia, rheumatoid arthritis, and other tick-borne illnesses.  Physical examination reveals [objective findings e.g., vital signs, lymphadenopathy, neurological assessment].  Laboratory testing ordered includes two-tiered serologic testing for Lyme disease antibodies (ELISA followed by Western blot if ELISA positive).  Preliminary diagnosis is consistent with [stage of Lyme disease, e.g., early localized Lyme disease].  Treatment plan includes [specific antibiotic regimen e.g., doxycycline 100mg twice daily for [duration] days].  Patient education provided on tick bite prevention, disease progression, potential complications (e.g., Lyme arthritis, neuroborreliosis, carditis), and medication side effects.  Follow-up appointment scheduled in [timeframe] to monitor treatment response and symptom resolution. ICD-10 code A69.20 (Lyme disease unspecified) and CPT codes for evaluation and management (e.g., 99203-99205 for new patient, 99212-99215 for established patient) and laboratory testing (e.g., 86618 for Lyme disease antibody testing) will be used for billing and coding purposes.  Medical necessity for testing and treatment documented.
Lyme Disease - AI-Powered ICD-10 Documentation