A96.1 ICD-10-CM Code: Machupo hemorrhagic fever
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Arthropod-borne viral fevers and viral hemorrhagic fevers (A90-A99)
A96.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMachupo hemorrhagic fever
Machupo hemorrhagic fever is a rare, severe viral infection transmitted by infected rodents that causes bleeding, high fever, and potentially life-threatening complications. It is endemic to Bolivia and is characterized by sudden onset of fever, muscle pain, and hemorrhagic manifestations.
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- Bolivian hemorrhagic fever
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A96.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A96.1 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A96.1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A96.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A96.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A96.1 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 A96.1 an HCC code?
No. A96.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A96.1 is the ICD-10-CM diagnosis code for machupo hemorrhagic fever. Machupo hemorrhagic fever is a rare, severe viral infection transmitted by infected rodents that causes bleeding, high fever, and potentially life-threatening complications. It is endemic to Bolivia and is characterized by sudden onset of fever, muscle pain, and hemorrhagic manifestations. A96.1 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).
A96.1 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.
This is a reportable disease in most jurisdictions; verify local public health reporting requirements when assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A96.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a reportable disease in most jurisdictions; verify local public health reporting requirements when assigning this code
- •Machupo fever is an Arenavirus infection; ensure documentation clearly identifies this specific hemorrhagic fever rather than other viral hemorrhagic fevers (Ebola, Marburg, Lassa, etc.) which have different codes