A68.9 ICD-10-CM Code: Relapsing fever, unspecified
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other spirochetal diseases (A65-A69)
A68.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRelapsing fever, unspecified
Relapsing fever is a bacterial infection transmitted by lice or ticks that causes recurring episodes of fever, chills, and body aches. This code is used when the specific type of relapsing fever (louse-borne or tick-borne) has not been documented or determined.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A68.9 in this effective period.
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 A68.9 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A68.9 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A68.9 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A68.9 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 A68.9 an HCC code?
No. A68.9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- A68.9
- Description
- Relapsing fever, unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
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
A68.9 is the ICD-10-CM diagnosis code for relapsing fever, unspecified. Relapsing fever is a bacterial infection transmitted by lice or ticks that causes recurring episodes of fever, chills, and body aches. This code is used when the specific type of relapsing fever (louse-borne or tick-borne) has not been documented or determined. A68.9 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other spirochetal diseases (a65-a69).
A68.9 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.
Query the provider if the type of relapsing fever can be determined, as A68.0 (louse-borne) and A68.1 (tick-borne) are more specific and preferred codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A68.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider if the type of relapsing fever can be determined, as A68.0 (louse-borne) and A68.1 (tick-borne) are more specific and preferred codes
- •Verify that the diagnosis is relapsing fever and not other febrile conditions; review clinical documentation for fever patterns, vector exposure history, and laboratory findings