A69.9 ICD-10-CM Code: Spirochetal infection, unspecified
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other spirochetal diseases (A65-A69)
A69.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSpirochetal infection, unspecified
This code is used when a patient has a confirmed spirochetal infection (a bacterial infection caused by spiral-shaped bacteria) but the specific type of spirochetal infection has not been identified or documented. Spirochetal infections include conditions like syphilis, Lyme disease, and leptospirosis.
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
OfficialICD-10-CM does not list inclusion terms for A69.9 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A69.9 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A69.9 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A69.9 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A69.9 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A69.9 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A69.9 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 A69.9 an HCC code?
No. A69.9 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
A69.9 is the ICD-10-CM diagnosis code for spirochetal infection, unspecified. This code is used when a patient has a confirmed spirochetal infection (a bacterial infection caused by spiral-shaped bacteria) but the specific type of spirochetal infection has not been identified or documented. Spirochetal infections include conditions like syphilis, Lyme disease, and leptospirosis. A69.9 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other spirochetal diseases (a65-a69).
A69.9 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.
This is an unspecified code and should only be used when the specific type of spirochetal infection cannot be determined from the medical record; always attempt to obtain more specific documentation from the provider.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A69.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is an unspecified code and should only be used when the specific type of spirochetal infection cannot be determined from the medical record; always attempt to obtain more specific documentation from the provider
- •Review the clinical presentation, lab results, and patient history to see if a more specific spirochetal infection code (A69.0-A69.8) can be assigned instead