A50.1
BillableEarly congenital syphilis, latent
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A50.1 an HCC code?
No. A50.1 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
A50.1 is the ICD-10-CM diagnosis code for early congenital syphilis, latent. This is a condition where a baby was infected with syphilis before birth from their mother, but the infection is in a hidden or dormant stage without active symptoms showing. The infection is present in the body but not currently causing visible signs of disease. A50.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering infections with a predominantly sexual mode of transmission (a50-a64).
A50.1 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.
This code is used specifically for congenital syphilis cases that are in the latent (asymptomatic) phase; do not use this code if the patient is showing active symptoms of early congenital syphilis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A50.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is used specifically for congenital syphilis cases that are in the latent (asymptomatic) phase; do not use this code if the patient is showing active symptoms of early congenital syphilis
- •Always verify the patient's age and confirm maternal syphilis history in the medical record, as this diagnosis applies only to infants and young children with documented congenital transmission