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ICD-10 Guide
ICD-10 CodesA83.4

A83.4

Eastern equine encephalitis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A83.4 is a billable code used to indicate a diagnosis of eastern equine encephalitis.

Key Diagnostic Point:

Eastern equine encephalitis (EEE) is a rare but serious viral infection that affects the central nervous system (CNS), primarily caused by the Eastern equine encephalitis virus (EEEV), which is transmitted through mosquito bites. The disease is characterized by sudden onset of fever, headache, and neurological symptoms, which may include confusion, seizures, and coma. EEE is particularly severe in young children and older adults, with a high mortality rate among those who develop encephalitis. The virus can lead to long-term neurological complications, including cognitive deficits, motor impairments, and behavioral changes. Diagnosis is typically confirmed through serological testing or PCR analysis of cerebrospinal fluid (CSF). Vaccination against EEE is available and is recommended for individuals at high risk, such as those living in endemic areas or working in certain outdoor occupations. Prompt recognition and supportive care are crucial for improving outcomes in affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating EEE from other viral encephalitides
  • Need for precise documentation of neurological symptoms
  • Variability in clinical presentation among patients
  • Potential for co-infection with other arboviruses

Audit Risk Factors

  • Inadequate documentation of clinical symptoms
  • Failure to document vaccination status
  • Misclassification of EEE as a less severe viral infection
  • Lack of laboratory confirmation in medical records

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and vaccination status.

Common Clinical Scenarios

Patients presenting with fever and neurological symptoms after mosquito exposure.

Billing Considerations

Ensure laboratory confirmation is documented to support coding.

Neurology

Documentation Requirements

Neurological examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients with acute encephalitis symptoms requiring neurological evaluation.

Billing Considerations

Document any long-term neurological sequelae for accurate coding.

Coding Guidelines

Inclusion Criteria

Use A83.4 When
  • Follow ICD
  • CM guidelines for coding infectious diseases, ensuring to document the specific type of encephalitis and any associated complications
  • Include any relevant laboratory findings and vaccination history

Exclusion Criteria

Do NOT use A83.4 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Arbovirus testing

Clinical Scenario

Used when testing for EEE in patients with encephalitis symptoms.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Infectious disease specialists should ensure comprehensive testing is performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of EEE, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and laboratory confirmation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of EEE, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and laboratory confirmation.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and laboratory confirmation.

Resources

Clinical References

  • •
    CDC - Eastern Equine Encephalitis

Coding & Billing References

  • •
    CDC - Eastern Equine Encephalitis

Frequently Asked Questions

What are the common symptoms of Eastern equine encephalitis?

Common symptoms include high fever, headache, chills, and neurological symptoms such as confusion, seizures, and coma.

How is Eastern equine encephalitis diagnosed?

Diagnosis is typically made through clinical evaluation, supported by serological testing or PCR analysis of cerebrospinal fluid.

Is there a vaccine for Eastern equine encephalitis?

Yes, there is a vaccine available for Eastern equine encephalitis, primarily recommended for individuals at high risk.