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ICD-10 Guide
ICD-10 CodesChapter 1: Certain infectious and parasitic diseasesA20.9

A20.9

Billable

Plague, unspecified

Chapter 1:Certain infectious and parasitic diseases

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

Code Description

ICD-10 A20.9 is a billable code used to indicate a diagnosis of plague, unspecified.

Key Diagnostic Point:

Plague is a severe infectious disease caused by the bacterium Yersinia pestis, primarily transmitted to humans through bites from infected fleas, contact with infected animals, or inhalation of respiratory droplets from infected individuals. The disease is characterized by fever, chills, weakness, and swollen lymph nodes, known as buboes, which can lead to severe complications if untreated. Plague is classified into three main forms: bubonic, septicemic, and pneumonic, with the unspecified code (A20.9) used when the specific type is not documented. Zoonotic in nature, plague primarily affects rodents and their fleas, making it a significant public health concern, especially in areas where these animals are prevalent. The disease can lead to outbreaks, necessitating effective surveillance and control measures to prevent transmission. Public health strategies include monitoring rodent populations, educating communities about prevention, and ensuring rapid response to suspected cases to mitigate the risk of widespread infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and documentation of plague types.
  • Need for precise identification of transmission vectors and exposure history.
  • Potential for misclassification with other zoonotic infections.
  • Requirement for thorough understanding of public health implications.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the type of plague when applicable.
  • Lack of detailed exposure history to zoonotic vectors.
  • Misalignment between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on symptoms, exposure history, and diagnostic tests.

Common Clinical Scenarios

Patients presenting with fever and lymphadenopathy after potential exposure to rodents.

Billing Considerations

Ensure all relevant laboratory results and epidemiological data are included.

Public Health

Documentation Requirements

Reports on outbreak investigations and surveillance data.

Common Clinical Scenarios

Monitoring and responding to plague outbreaks in endemic areas.

Billing Considerations

Documentation should reflect community health assessments and preventive measures taken.

Coding Guidelines

Inclusion Criteria

Use A20.9 When
  • According to ICD
  • 10 coding guidelines, A20
  • 9 should be used when the specific type of plague is not documented
  • Coders must ensure that the diagnosis aligns with clinical findings and that any relevant exposure history is noted
  • It is essential to follow local public health reporting requirements

Exclusion Criteria

Do NOT use A20.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

87070CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when laboratory confirmation of plague is required.

Documentation Requirements

Document the source of the culture and clinical indications.

Specialty Considerations

Infectious disease specialists should ensure all relevant cultures are ordered.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of plague and related conditions, improving data accuracy and public health reporting. A20.9 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of plague and related conditions, improving data accuracy and public health reporting. A20.9 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of plague and related conditions, improving data accuracy and public health reporting. A20.9 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

Resources

Clinical References

  • •
    CDC Plague Information

Coding & Billing References

  • •
    CDC Plague Information

Frequently Asked Questions

What should I document to support the use of A20.9?

Document clinical symptoms, exposure history, and any relevant laboratory findings. Ensure that the diagnosis aligns with the clinical presentation.