A69.20 ICD-10-CM Code: Lyme disease, unspecified
A69.20 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other spirochetal diseases (A65-A69)
A69.20
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLyme disease, unspecified
Lyme disease is an infection spread by tick bites that can affect the joints, heart, and nervous system. This code is used when the specific type or stage of Lyme disease has not been determined or documented.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Erythema chronicum migrans due to Borrelia burgdorferiInherited from A69.2
Excludes 2
Official- carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99, A65-A69
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99, A65-A69
- infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99, A65-A69
- influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99, A65-A69
- leptospirosis (A27.-)Inherited from A00-B99, A65-A69
- syphilis (A50-A53)Inherited from A00-B99, A65-A69
Related Codes
Includes
Official- diseases generally recognized as communicable or transmissibleInherited from A00-B99
Excludes 1
Official- certain localized infections - see body system-related chaptersInherited from A00-B99
Code First
OfficialNo Code First sequencing instructions are included in this display for A69.20. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99
Code Also
OfficialNo Code Also instructions are included in this display for A69.20. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is A69.20 an HCC code?
No. A69.20 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- A69.20
- Description
- Lyme disease, unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
A69.20 is the ICD-10-CM diagnosis code for lyme disease, unspecified. Lyme disease is an infection spread by tick bites that can affect the joints, heart, and nervous system. This code is used when the specific type or stage of Lyme disease has not been determined or documented. A69.20 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other spirochetal diseases (a65-a69).
A69.20 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Use more specific Lyme disease codes (A69.21 for meningitis, A69.22 for other neurologic manifestations, A69.23 for arthritis) if the clinical documentation specifies the affected body system or manifestation.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A69.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use more specific Lyme disease codes (A69.21 for meningitis, A69.22 for other neurologic manifestations, A69.23 for arthritis) if the clinical documentation specifies the affected body system or manifestation
- •Verify that the patient has confirmed Lyme disease diagnosis; if only suspected or ruled out, different coding may apply. Document the stage of disease when possible to support more specific coding