A68.1 ICD-10-CM Code: Tick-borne relapsing fever
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other spirochetal diseases (A65-A69)
A68.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceTick-borne relapsing fever
Tick-borne relapsing fever is an infectious disease transmitted through the bite of infected ticks, characterized by recurring episodes of fever, chills, and body aches. The fever typically comes and goes in cycles as the bacteria evades the immune system.
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- Relapsing fever due to any Borrelia species other than Borrelia recurrentis
Excludes 2
Official- Lyme disease (A69.2-)
Related Child Codes
Includes
Official- recurrent fever
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A68.1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A68.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A68.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A68.1 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 A68.1 an HCC code?
No. A68.1 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
A68.1 is the ICD-10-CM diagnosis code for tick-borne relapsing fever. Tick-borne relapsing fever is an infectious disease transmitted through the bite of infected ticks, characterized by recurring episodes of fever, chills, and body aches. The fever typically comes and goes in cycles as the bacteria evades the immune system. A68.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other spirochetal diseases (a65-a69).
A68.1 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.
Verify the documentation specifies 'tick-borne' relapsing fever (A68.1) rather than louse-borne relapsing fever (A68.0), as the vector type is clinically and epidemiologically important.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A68.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the documentation specifies 'tick-borne' relapsing fever (A68.1) rather than louse-borne relapsing fever (A68.0), as the vector type is clinically and epidemiologically important
- •Ensure the diagnosis is confirmed by the provider; relapsing fever requires specific laboratory testing or clinical documentation linking symptoms to tick exposure in endemic areas