B69.81 ICD-10-CM Code: Myositis in cysticercosis
B69.81 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Helminthiases (B65-B83)
B69.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMyositis in cysticercosis
This condition occurs when tapeworm larvae (cysticercus) infect the muscles, causing inflammation and muscle pain. It results from eating undercooked meat contaminated with tapeworm eggs, typically from pork or beef.
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
OfficialNo inclusion terms are included in this display for B69.81. Check the code and parent instructions in the Code Book.
Excludes 2
Official- carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
- infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
- influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99
Related Codes
Includes
Official- diseases generally recognized as communicable or transmissibleInherited from A00-B99, B69
- cysticerciasis infection due to larval form of Taenia soliumInherited from A00-B99, B69
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 B69.81. 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 B69.81. 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 B69.81 an HCC code?
No. B69.81 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
- B69.81
- Description
- Myositis in cysticercosis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
B69.81 is the ICD-10-CM diagnosis code for myositis in cysticercosis. This condition occurs when tapeworm larvae (cysticercus) infect the muscles, causing inflammation and muscle pain. It results from eating undercooked meat contaminated with tapeworm eggs, typically from pork or beef. B69.81 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering helminthiases (b65-b83).
B69.81 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.
Always code the underlying cysticercosis first (B69.8-) before coding the myositis manifestation, as B69.81 is a manifestation code.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B69.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.