2024 ICD-10-CM Diagnosis Code A69.2

Specific Coding Applicable to Lyme disease

Non-specific codes like A69.2 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for lyme disease:

Clinical Information

• Borrelia burgdorferi

  a specific species of bacteria, part of the borrelia burgdorferi group, whose common name is lyme disease spirochete.

• Lyme Disease

  an infectious disease caused by a spirochete, borrelia burgdorferi, which is transmitted chiefly by ixodes dammini (see ixodes) and pacificus ticks in the united states and ixodes ricinis (see ixodes) in europe. it is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. the disease was formerly known as lyme arthritis and first discovered at old lyme, connecticut.

• Lyme Disease Vaccines

  vaccines or candidate vaccines used to prevent lyme disease.

• Lyme Neuroborreliosis

  nervous system infections caused by tick-borne spirochetes of the borrelia burgdorferi group. the disease may affect elements of the central or peripheral nervous system in isolation or in combination. common clinical manifestations include a lymphocytic meningitis, cranial neuropathy (most often a facial neuropathy), polyradiculopathy, and a mild loss of memory and other cognitive functions. less often more extensive inflammation involving the central nervous system (encephalomyelitis) may occur. in the peripheral nervous system, b. burgdorferi infection is associated with mononeuritis multiplex and polyradiculoneuritis. (from j neurol sci 1998 jan 8;153(2):182-91)

• Post-Lyme Disease Syndrome

  a condition caused by long-lasting and ongoing infection with the spirochete borrelia burgdorferi resulting in progressive inflammatory neurologic, neuromuscular, and dermatologic manifestations including encephalitis; myelitis; acrodermatitis chronica atrophicans; and arthritis.

• Borrelia burgdorferi Group

  gram-negative helical bacteria, in the genus borrelia, that are the etiologic agents of lyme disease. the group comprises many specific species including borrelia afzelii, borellia garinii, and borrelia burgdorferi proper. these spirochetes are generally transmitted by several species of ixodid ticks.

Patient Education

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

[Learn More in MedlinePlus]

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.

[Learn More in MedlinePlus]

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.