Pediatric Coding Alert

Tip: Lyme disease series expands out to five codes under ICD-10.

With Lyme disease coding being tricky to begin with, you're in for more excitement once the diagnosis coding system switches over to ICD-10.

As outlined in our article, "Determine Whether Your Lyme Disease Code Assignment Makes the Grade," you should currently report 088.81 (Lyme disease) if a patient has a confirmed case of Lyme disease. Under ICD-10, however, your coding options will expand to the following code set:

• A69.20, Lyme disease, unspecified
• A69.21, Meningitis due to Lyme disease
• A69.22, Other neurologic disorders in Lyme disease
• A69.23, Arthritis due to Lyme disease
• A69.29, Other conditions associated with Lyme disease

Documentation: Under the ICD-10 code system, you will need to clearly note whether the patient has Lyme disease alone (A69.20) or Lyme disease with other contributing factors (A69.21-A69.22). For instance, you cannot report A69.21 unless the documentation includes confirmation that the patient suffers from meningitis as well as Lymedisease, and that the two conditions are related.

You should not report the Lyme disease diagnosis code unless your practice receives confirmation from a lab test indicating that the patient tested positive for a Lyme disease. If you don't have a positive lab test confirming Lyme disease, you should simply report the diagnosis codes for the symptoms (such as fever, a bulls-eye rash, myalgias, etc.)

Therefore, your documentation must include a copy of the laboratory report confirming that the patient had Lyme disease before you select your diagnosis code.