A20.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupA20.1

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Certain zoonotic bacterial diseases (A20-A28)

A20.1

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Cellulocutaneous plague

Cellulocutaneous plague is a form of plague infection that affects the skin and underlying tissues, causing swelling, inflammation, and tissue damage at the site of infection. This type of plague typically develops when the bacterium Yersinia pestis enters through a break in the skin or is transmitted through an insect bite.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

A20Plague A20.1Cellulocutaneous plague

Inclusion Terms

Official

No inclusion terms are included in this display for A20.1. Check the code and parent instructions in the Code Book.

Excludes 2

Official

carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99

Related Codes

Official

A20.0Bubonic plague A20.2Pneumonic plague A20.3Plague meningitis A20.7Septicemic plague A20.8Other forms of plague

Includes

Official

diseases generally recognized as communicable or transmissibleInherited from A00-B99, A20
infection due to Yersinia pestisInherited from A00-B99, A20

Excludes 1

Official

certain localized infections - see body system-related chaptersInherited from A00-B99

Code First

Official

No Code First sequencing instructions are included in this display for A20.1. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99

Code Also

Official

No Code Also instructions are included in this display for A20.1. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Ensure documentation clearly indicates the cellulocutaneous presentation (skin and subcutaneous tissue involvement) rather than other plague forms like bubonic or pneumonic plague

Verify that the plague diagnosis is confirmed and documented by the provider; this code should not be used for suspected or ruled-out cases

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is A20.1 an HCC code?

No. A20.1 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: A20.1
Description: Cellulocutaneous plague
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

A20.1 is the ICD-10-CM diagnosis code for cellulocutaneous plague. Cellulocutaneous plague is a form of plague infection that affects the skin and underlying tissues, causing swelling, inflammation, and tissue damage at the site of infection. This type of plague typically develops when the bacterium Yersinia pestis enters through a break in the skin or is transmitted through an insect bite. A20.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering certain zoonotic bacterial diseases (a20-a28).

A20.1 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Ensure documentation clearly indicates the cellulocutaneous presentation (skin and subcutaneous tissue involvement) rather than other plague forms like bubonic or pneumonic plague.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A20.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation clearly indicates the cellulocutaneous presentation (skin and subcutaneous tissue involvement) rather than other plague forms like bubonic or pneumonic plague
•Verify that the plague diagnosis is confirmed and documented by the provider; this code should not be used for suspected or ruled-out cases