ICD-10 Coding for Erythema Migrans(A69.20, A26.0)
Complete ICD-10-CM coding and documentation guide for Erythema Migrans. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Erythema Migrans
A69.20-A69.29Primary Range
Lyme disease
Erythema migrans is a primary sign of Lyme disease and should be coded under this range when Lyme is suspected.
Cutaneous erysipeloid
Used only if erythema migrans is confirmed as a non-Lyme bacterial infection.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A69.20 | Lyme disease, unspecified | Use when erythema migrans is present with clinical suspicion of Lyme disease. |
|
| A26.0 | Cutaneous erysipeloid | Use when erythema migrans is confirmed as a non-Lyme bacterial infection. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for erythema migrans
Essential facts and insights about Erythema Migrans
Primary ICD-10-CM Codes for erythema migrans
Decision Criteria
clinical Criteria
- Presence of erythema migrans with history of tick exposure.
documentation Criteria
- Document rash size and expansion.
Applicable To
- Erythema migrans when Lyme disease is suspected
Excludes
- Cutaneous erysipeloid (A26.0)
Clinical Validation Requirements
- Rash ≥5 cm with documented expansion
- Tick exposure in endemic area
- Absence of cellulitis/alternative diagnoses
Code-Specific Risks
- Incorrectly coding as A26.0 without confirmation of non-Lyme infection.
Coding Notes
- Ensure documentation links erythema migrans to Lyme disease suspicion.
A26.0 - Cutaneous erysipeloid
Use when erythema migrans is confirmed as a non-Lyme bacterial infection.
Applicable To
- Erysipelothrix rhusiopathiae infection
Excludes
- Lyme disease (A69.20)
Clinical Validation Requirements
- Culture-positive Erysipelothrix infection
- Occupational exposure history
Coding Notes
Only use when erythema migrans is confirmed as non-Lyme.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Tick bite
W57.XXXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Erythema Migrans to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A69.20.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Train staff on detailed documentation., Use templates for consistency.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with clinical guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Ensure clinical suspicion of Lyme disease is documented before using A69.20.
Impact
Using A26.0 instead of A69.20 without proper confirmation.
Mitigation Strategy
Ensure documentation supports Lyme disease suspicion.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Erythema Migrans, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Erythema Migrans
Use these documentation templates to ensure complete and accurate documentation for Erythema Migrans. These templates include all required elements for proper coding and billing.
Patient with erythema migrans and tick exposure
Specialty: Primary CareRequired Elements
- Rash description
- Tick exposure history
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Erythema Migrans? Ask your questions below.