A93.1 ICD-10-CM Code: Sandfly fever
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) / Arthropod-borne viral fevers and viral hemorrhagic fevers (A90-A99)
A93.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSandfly fever
Sandfly fever is a viral infection transmitted through the bite of infected sandflies, causing symptoms like fever, headache, and body aches. It is typically a self-limiting illness that resolves within a few days to weeks.
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
Official- Pappataci fever
- Phlebotomus fever
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A93.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A93.1 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A93.1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A93.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A93.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A93.1 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 A93.1 an HCC code?
No. A93.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- A93.1
- Description
- Sandfly fever
- 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
A93.1 is the ICD-10-CM diagnosis code for sandfly fever. Sandfly fever is a viral infection transmitted through the bite of infected sandflies, causing symptoms like fever, headache, and body aches. It is typically a self-limiting illness that resolves within a few days to weeks. A93.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering arthropod-borne viral fevers and viral hemorrhagic fevers (a90-a99).
A93.1 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 specific type of sandfly fever (Pappataci fever or other variants) in the clinical documentation, as this may affect treatment and reporting requirements.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A93.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific type of sandfly fever (Pappataci fever or other variants) in the clinical documentation, as this may affect treatment and reporting requirements
- •Ensure the code is used only when sandfly fever is confirmed or suspected based on clinical presentation and epidemiological exposure; document the geographic location or travel history when available