A30.4 ICD-10-CM Code: Borderline lepromatous leprosy
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other bacterial diseases (A30-A49)
A30.4
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBorderline lepromatous leprosy
Borderline lepromatous leprosy is a form of Hansen's disease (leprosy) that falls between the lepromatous and borderline tuberculoid types, characterized by numerous bacteria in the skin and nerves with moderate immune response. This is a chronic infectious disease caused by Mycobacterium leprae that affects the skin and peripheral nerves.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- BL leprosy
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A30.4 in this effective period.
Related Child Codes
Includes
Official- infection due to Mycobacterium leprae
Excludes 1
Official- sequelae of leprosy (B92)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A30.4 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A30.4 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A30.4 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is A30.4 an HCC code?
No. A30.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A30.4 is the ICD-10-CM diagnosis code for borderline lepromatous leprosy. Borderline lepromatous leprosy is a form of Hansen's disease (leprosy) that falls between the lepromatous and borderline tuberculoid types, characterized by numerous bacteria in the skin and nerves with moderate immune response. This is a chronic infectious disease caused by Mycobacterium leprae that affects the skin and peripheral nerves. A30.4 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).
A30.4 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.
Verify the specific type of leprosy documented by the physician, as A30 codes are differentiated by leprosy classification (tuberculoid, borderline tuberculoid, borderline, borderline lepromatous, and lepromatous).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A30.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific type of leprosy documented by the physician, as A30 codes are differentiated by leprosy classification (tuberculoid, borderline tuberculoid, borderline, borderline lepromatous, and lepromatous)
- •Leprosy is a reportable disease in most jurisdictions; ensure proper documentation and consider adding a code for any complications such as neuritis (G63.8) or skin manifestations if separately documented