ICD-10 Coding for History of Lyme Disease(Z86.1, A69.20)
Complete ICD-10-CM coding and documentation guide for History of Lyme Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Lyme Disease
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.1 | Personal history of infectious and parasitic diseases | Use when Lyme disease is resolved and there are no active symptoms. |
|
| A69.20 | Lyme disease, unspecified | Use for active Lyme disease cases. |
|
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 history of Lyme disease
Essential facts and insights about History of Lyme Disease
Primary ICD-10-CM Codes for history of lyme disease
Decision Criteria
clinical Criteria
- Patient has no active symptoms and Lyme disease is resolved.
Applicable To
- Resolved Lyme disease
Excludes
- Active Lyme disease (A69.2X)
Clinical Validation Requirements
- Documentation of resolved Lyme disease
- No active symptoms present
- Past treatment details
Code-Specific Risks
- Incorrectly coding active Lyme as history
Coding Notes
- Ensure documentation clearly states the resolution of Lyme disease.
A69.20 - Lyme disease, unspecified
Use for active Lyme disease cases.
Applicable To
- Active Lyme disease
Excludes
- Resolved Lyme disease (Z86.1)
Clinical Validation Requirements
- Presence of active symptoms
- Positive lab tests for Lyme
Coding Notes
Ensure active symptoms and lab confirmation are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Lyme Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.1.
Impact
Clinical: Leads to confusion about disease status., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include resolution details in patient records.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use A69.2X for active cases until symptoms resolve.
Impact
Using Z86.1 for active cases can trigger audits.
Mitigation Strategy
Ensure accurate documentation of disease status.
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 History of Lyme Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Lyme Disease
Use these documentation templates to ensure complete and accurate documentation for History of Lyme Disease. These templates include all required elements for proper coding and billing.
Post-treatment follow-up for Lyme disease
Specialty: Primary CareRequired Elements
- Resolution statement
- Treatment details
- Absence of symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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