# tick bite



## rleif1sun (Nov 14, 2018)

which ICD10 code is correct to report when patient is seen to check for lyme disease 6 weeks after tick bite. bite is resolved at this visit. our providers code W57.XXXD (Bitten or stung by nonvenomous insect and other nonvenomous arthropods, subsequent encounter). is this code correct code although bite has been resolved? or screening code Z11.8(Encounter for screening for other infectious and parasitic diseases) ?


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## thomas7331 (Nov 14, 2018)

rleif1sun said:


> which ICD10 code is correct to report when patient is seen to check for lyme disease 6 weeks after tick bite. bite is resolved at this visit. our providers code W57.XXXD (Bitten or stung by nonvenomous insect and other nonvenomous arthropods, subsequent encounter). is this code correct code although bite has been resolved? or screening code Z11.8(Encounter for screening for other infectious and parasitic diseases) ?



The external cause code for the bite cannot be used as a primary diagnosis, and Z11.8 is not correct because the patient is not asymptomatic and this encounter would not meet the definition of a screening.  

For a primary diagnosis, depending on documentation, I would recommend either Z20.818 for the suspected exposure to a bacterial disease, or Z03.89 if the Lyme disease has definitely been ruled out.


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## rleif1sun (Nov 14, 2018)

thomas7331 said:


> The external cause code for the bite cannot be used as a primary diagnosis, and Z11.8 is not correct because the patient is not asymptomatic and this encounter would not meet the definition of a screening.
> 
> For a primary diagnosis, depending on documentation, I would recommend either Z20.818 for the suspected exposure to a bacterial disease, or Z03.89 if the Lyme disease has definitely been ruled out.




tnx so much

what if pt comes in for tick bite on right shoulder and provider removed tick for which primary diag is reported as S40.261A-(Insect bite (nonvenomous) of right shoulder, initial encounter). provider instructed patient to come back few week for lyme test. can i report  S40.261D-(Insect bite (nonvenomous) of right shoulder, subsequent encounter) at subsequent visit where blood was drawn for lyme test? or only Z20.818?


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## thomas7331 (Nov 14, 2018)

rleif1sun said:


> tnx so much
> 
> what if pt comes in for tick bite on right shoulder and provider removed tick for which primary diag is reported as S40.261A-(Insect bite (nonvenomous) of right shoulder, initial encounter). provider instructed patient to come back few week for lyme test. can i report  S40.261D-(Insect bite (nonvenomous) of right shoulder, subsequent encounter) at subsequent visit where blood was drawn for lyme test? or only Z20.818?



Personally, I do not think the bite codes are appropriate because in most cases the provider is not treating the bite (it is usually a superficial injury that doesn't require treatment or follow-up care) and the treatment is directed solely at the potential exposure to disease that accompanies it and not at the wound or injury itself.  However you have to go by what best represents what the provider is documenting.  

Also, I'd just add that a tick is an arthropod and not an insect, so an insect bite code it is technically not correct - if the provider is documenting treating a tick bite, I would use the 'other superficial bite' codes for this.


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