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v1.0.0
ICD-10 Guide
ICD-10 CodesA68

A68

Relapsing fever

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

Code Description

ICD-10 A68 is a billable code used to indicate a diagnosis of relapsing fever.

Key Diagnostic Point:

Relapsing fever is an infectious disease characterized by recurrent episodes of fever, typically caused by spirochetes of the genus Borrelia. The disease is transmitted primarily through the bite of infected lice or ticks, with Borrelia hermsii and Borrelia recurrentis being the most common causative agents. Clinically, patients present with sudden onset of high fever, chills, headache, and myalgia, followed by periods of afebrile intervals. The relapsing nature of the fever is due to the spirochetes' ability to evade the host's immune response through antigenic variation. Geographic distribution of relapsing fever is largely dependent on the vector; for instance, louse-borne relapsing fever is prevalent in crowded and unsanitary conditions, often seen in refugee camps or areas with poor hygiene. Tick-borne relapsing fever is more common in rural areas of Africa, the Americas, and parts of Europe. Diagnosis is typically made through blood smear microscopy or serological tests. Treatment involves the use of antibiotics, with doxycycline being the first-line therapy. Understanding the epidemiology and clinical presentation is crucial for timely diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of causative agents (different Borrelia species)
  • Differentiation between louse-borne and tick-borne forms
  • Potential for co-infections with other vector-borne diseases
  • Need for accurate documentation of geographic exposure

Audit Risk Factors

  • Inadequate documentation of patient history related to travel or exposure
  • Failure to specify the type of relapsing fever (louse-borne vs. tick-borne)
  • Misdiagnosis or coding of similar febrile illnesses
  • Lack of supporting lab results in the medical record

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed travel history, exposure risks, and laboratory results.

Common Clinical Scenarios

Patients presenting with recurrent fevers and travel history to endemic areas.

Billing Considerations

Ensure accurate identification of the Borrelia species involved.

Primary Care

Documentation Requirements

Comprehensive patient history and symptom tracking.

Common Clinical Scenarios

Patients with febrile illness returning from endemic regions.

Billing Considerations

Consider differential diagnoses and document any relevant travel history.

Coding Guidelines

Inclusion Criteria

Use A68 When
  • Follow the official ICD
  • CM coding guidelines, ensuring to document the specific type of relapsing fever and any associated symptoms
  • Include relevant laboratory findings and patient history to support the diagnosis

Exclusion Criteria

Do NOT use A68 When
No specific exclusions found.

Related Codes

Child Codes

3 codes
A68.0
Infections caused by Escherichia coli [E. coli] in diseases classified elsewhere
A68.1
Epidemic louse-borne typhus
A68.9
Relapsing fever, unspecified

Related CPT Codes

87070CPT Code

Blood culture, bacterial, aerobic, and anaerobic

Clinical Scenario

Used to confirm the presence of Borrelia species in suspected cases of relapsing fever.

Documentation Requirements

Document the clinical suspicion of relapsing fever and the need for blood cultures.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of the clinical rationale.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of relapsing fever, enabling better tracking of epidemiological data and improving the accuracy of treatment protocols.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of relapsing fever, enabling better tracking of epidemiological data and improving the accuracy of treatment protocols.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of relapsing fever, enabling better tracking of epidemiological data and improving the accuracy of treatment protocols.

Resources

Clinical References

  • •
    CDC - Relapsing Fever

Coding & Billing References

  • •
    CDC - Relapsing Fever

Frequently Asked Questions

What are the common symptoms of relapsing fever?

Common symptoms include recurrent episodes of high fever, chills, headache, muscle aches, and fatigue. The fever typically lasts for 3-7 days, followed by an afebrile period.

How is relapsing fever diagnosed?

Diagnosis is made through blood smear microscopy to identify spirochetes or through serological tests. A detailed travel history is also crucial.