A20.1
BillableCellulocutaneous plague
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A20.1 an HCC code?
No. A20.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
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 does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
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, RAF weights, 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