Use an ‘Other’ Code to Best Capture African Tick Bite Fever
Question: I’m reading notes for a recent patient encounter. The patient presented with fever, headache, muscle pain, and several black-centered skin lesions, which the provider described later in the note as eschars. The physician documented that the patient recently returned from a three-week teaching assignment in a South African game park and diagnosed African tick bite fever. What ICD-10-CM code should I report? New York Subscriber Answer: In this situation, you may report A77.8 (Other spotted fevers) for the diagnosis of African tick bite fever. The physician has established a definitive diagnosis of African tick bite fever, and the presenting symptoms — fever, headache, myalgia, and eschars — are generally considered manifestations of the condition and typically are not coded separately unless the classification system or payer guidance specifically requires otherwise. African tick bite fever is caused by Rickettsia africae, a member of the spotted fever group rickettsiae. At this time, ICD-10-CM does not contain a unique code specifically named “African tick bite fever.” When a condition does not have its own code, you should assign the code that most accurately reflects the documented diagnosis within the classification — which, in this case, is A77.8. Also, important to remember: While the patient’s recent travel to South Africa may help support the clinical diagnosis, travel history alone does not determine code selection. Within category A77.- (Spotted fever [tick-borne rickettsioses]), the available codes identify certain named spotted fevers separately (for example, Rocky Mountain spotted fever), while other spotted fever group infections are classified in A77.8 (Other spotted fevers). Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC 
