A69.23
A69.23: Arthritis due to Lyme disease
Billable / specific codeICD-10-CM
A69.23 is a billable, specific ICD-10-CM code for arthritis due to lyme disease. It is valid for submission on a claim.
Check A69.23 with the rest of the claim: free scrubberOther codes that can never be billed with A69.23
Their own Excludes1 notes name this code, so the conflict is not listed above.
- M01Direct infections of joint in infectious and parasitic diseases classified elsewhere
Risk adjustment
A69.23 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis0.479 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
A69.23 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
- A56781Billing and Coding: Transthoracic Echocardiography (TTE)
- A57306Billing and Coding: Transthoracic Echocardiography (TTE)
Alphabetic index entries that lead here
- Arthritis, arthritic›due to or associated with›Lyme disease
- Arthritis, arthritic›in›Lyme disease
Code history
Unchanged in every release from FY2024 to FY2027.