2024 ICD-10-CM Diagnosis Code A69.23

Arthritis due to Lyme disease

ICD-10-CM Code:
A69.23
ICD-10 Code for:
Arthritis due to Lyme disease
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Certain infectious and parasitic diseases
    (A00–B99)
    • Other spirochetal diseases
      (A65-A69)
      • Other spirochetal infections
        (A69)

A69.23 is a billable diagnosis code used to specify a medical diagnosis of arthritis due to lyme disease. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Arthritis caused by spirochaetale infection
  • Arthritis caused by spirochaetale infection
  • Lyme arthritis
  • Lyme arthritis of knee joint
  • Skeletal Lyme disease
  • Skeletal Lyme disease

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Infective arthritisMUS001Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Parasitic, other specified and unspecified infectionsINF009N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Lyme Arthritis

    joint inflammation, most often affecting large joints, associated with lyme disease, presenting months after infection.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Convert A69.23 to ICD-9-CM

  • ICD-9-CM Code: 088.81 - Lyme disease
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Infectious Arthritis

Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection comes from a bacterial, viral, or fungal infection that spreads from another part of the body. Symptoms of infectious arthritis include:

  • Intense pain in the joint
  • Joint redness and swelling
  • Chills and fever
  • Inability to move the area with the infected joint

One type of infectious arthritis is reactive arthritis. The reaction is to an infection somewhere else in your body. The joint is usually the knee, ankle, or toe. Sometimes, reactive arthritis is set off by an infection in the bladder, or in the urethra, which carries urine out of the body. In women, an infection in the vagina can cause the reaction. For both men and women, it can start with bacteria passed on during sex. Another form of reactive arthritis starts with eating food or handling something that has bacteria on it.

To diagnose infectious arthritis, your health care provider may do tests of your blood, urine, and joint fluid. Treatment includes medicines and sometimes surgery.


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Lyme Disease

What is Lyme disease?

Lyme disease is a bacterial infection you get from the bite of an infected tick. At first, Lyme disease usually causes symptoms such as a rash, fever, headache, and fatigue. But if it is not treated early, the infection can spread to your joints, heart, and nervous system. Prompt treatment can help you recover quickly.

What causes Lyme disease?

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks). They are usually found in the:

  • Northeast
  • Mid-Atlantic
  • Upper Midwest
  • Pacific coast, especially northern California

These ticks can attach to any part your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually the tick must be attached to you for 36 to 48 hours or more to spread the bacterium to you.

Who is at risk for Lyme disease?

Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks.

Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.

What are the symptoms of Lyme disease?

Early symptoms of Lyme disease start between 3 to 30 days after an infected tick bites you. The symptoms can include:

  • A red rash called erythema migrans (EM). Most people with Lyme disease get this rash. It gets bigger over several days and may feel warm. It is usually not painful or itchy. As it starts to get better, parts of it may fade. Sometimes this makes the rash look like a "bull's-eye."
  • Fever
  • Chills
  • Headache
  • Fatigue
  • Muscle and joint aches
  • Swollen lymph nodes

If the infection is not treated, it can spread to your joints, heart, and nervous system. The symptoms may include:

  • Severe headaches and neck stiffness
  • Additional EM rashes on other areas of your body
  • Facial palsy, which is a weakness in your facial muscles. It can cause drooping on one or both sides of your face.
  • Arthritis with severe joint pain and swelling, especially in your knees and other large joints
  • Pain that comes and goes in your tendons, muscles, joints, and bones
  • Heart palpitations, which are feelings that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast
  • An irregular heart beat (Lyme carditis)
  • Episodes of dizziness or shortness of breath
  • Inflammation of the brain and spinal cord
  • Nerve pain
  • Shooting pains, numbness, or tingling in the hands or feet

How is Lyme disease diagnosed?

To make a diagnosis, your health care provider will consider:

  • Your symptoms
  • How likely it is that you were exposed to infected blacklegged ticks
  • The possibility that other illnesses may cause similar symptoms
  • Results of any lab tests

Most Lyme disease tests check for antibodies made by the body in response to infection. These antibodies can take several weeks to develop. If you are tested right away, it may not show that you have Lyme disease, even if you have it. So you may need to have another test later.

What are the treatments for Lyme disease?

Lyme disease is treated with antibiotics. The earlier you are treated, the better; it gives you the best chance of fully recovering quickly.

After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome (PTLDS). Researchers don't know why some people have PTLDS. There is no proven treatment for PTLDS; long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel all better.

Can Lyme disease be prevented?

To prevent Lyme disease, you should lower your risk of getting a tick bite:

  • Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
  • Use an insect repellent with DEET
  • Treat your clothing and gear with a repellant containing 0.5% permethrin
  • Wear light-colored protective clothing, so you can easily see any ticks that get on you
  • Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
  • Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
  • Take a shower and wash and dry your clothes at high temperatures after being outdoors

Centers for Disease Control and Prevention


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Lyme disease

Lyme disease is an infectious disease caused by Borrelia burgdorferi bacteria. The bacteria are transferred to humans by tick bite, specifically by blacklegged ticks (commonly known as deer ticks). The condition is named for the location in which it was first described, the town of Lyme, Connecticut.

If not treated with antibiotics, Lyme disease follows three stages: early localized, early disseminated, and late disseminated infection. A small percentage of individuals have symptoms that persist months or years after treatment, which is called post-treatment Lyme disease syndrome.

A characteristic feature of Lyme disease, and the key feature of early localized infection, is a slowly expanding red rash on the skin (called erythema migrans) at the site of the tick bite; the rash is often bull's-eye shaped. Flu-like symptoms and enlarged lymph nodes (lymphadenopathy) are also early signs of infection. Most people who are treated at this stage never develop further symptoms.

The early disseminated stage of Lyme disease occurs as the bacteria is carried throughout the body in the bloodstream. This stage occurs a few weeks after the tick bite. Signs and symptoms can include additional rashes on other parts of the body, flu-like symptoms, and lymphadenopathy. Some affected individuals develop neurologic problems (referred to as neuroborreliosis), such as paralyzed muscles in the face (facial palsy); pain, numbness, or weakness in the hands or feet; difficulty concentrating; or memory problems. Rarely, the heart is affected (Lyme carditis), causing a sensation of fluttering or pounding in the chest (palpitations) or an irregular heartbeat.

The late disseminated stage of Lyme disease can occur months to years after the tick bite. The most common feature of this stage, Lyme arthritis, is characterized by episodes of joint pain and swelling, usually affecting the knees. In rare cases, the late disseminated stage also involves neurological problems.

Individuals with post-treatment Lyme disease syndrome report ongoing exhaustion (fatigue), muscle and joint achiness, headache, or difficulty concentrating even after treatment with antibiotics, when there is no evidence of the bacteria in the body. Very rarely, individuals have joint pain and swelling for months or years after successful antibiotic treatment. This complication is called antibiotic-refractory Lyme arthritis.


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Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.