A69.8 ICD-10-CM Code: Other specified spirochetal infections

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for A69.8 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on A69.8 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for A69.8

MedCoder structured workflow — derived from this code’s own official record

Before you code A69.8

1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on A69.8; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

   ReviewA69.0, A69.2

   See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Any detail beyond this code’s title

What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

• Excludes2 — not part of A69.8(2 notes)

  Coding workflow: The conditions named in this note are not included in A69.8. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareA27

  See the official tabular notes · Guidelines I.A.12.b

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (16)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), Castellani's
• Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), spirochetal NEC
• Bronchospirochetosis
• Bronchospirochetosis, Castellani
• Castellani's disease
• Disease, diseased, Castellani's
• Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer), lung, spirochetal
• Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer), spirochetal NEC
• Infection, infected, infective (opportunistic), lung, spirochetal
• Infection, infected, infective (opportunistic), spirochetal NOS, lung
• Infection, infected, infective (opportunistic), spirochetal NOS, specified NEC
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), in (due to), spirochetal NEC
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), spirochetal NEC
• Spirochetosis, bronchopulmonary
• Spirochetosis, lung
• Ulcer, ulcerated, ulcerating, ulceration, ulcerative, nose, nasal (passage) (infective) (septum), spirochetal

Don’t confuse A69.8 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of A69.8 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• A69.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Spirochetal infection, unspecified” takes A69.9; specificity in the record moves it back here.

  Full comparison: A69.8 vs A69.9 →

• A27— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of leptospirosis adds A27; it is not part of this code and both may be reported when both are documented.

  Full comparison: A69.8 vs A27 →

• A50— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of syphilis adds A50; it is not part of this code and both may be reported when both are documented.

  Full comparison: A69.8 vs A50 →

• A53— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of syphilis adds A53; it is not part of this code and both may be reported when both are documented.

  Full comparison: A69.8 vs A53 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name A69.8 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: J15 — Bacterial pneumonia, not elsewhere classified, J17 — Pneumonia in diseases classified elsewhere.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 867 (MDC 18), DRG 868 (MDC 18), DRG 869 (MDC 18).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INF009 — Parasitic, other specified and unspecified infections (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Parasitic, other specified and unspecified infections).

A68.0 — Louse-borne relapsing fever, A68.1 — Tick-borne relapsing fever, A68.9 — Relapsing fever, unspecified, A69.0 — Necrotizing ulcerative stomatitis, A69.1 — Other Vincent's infections, 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, A69.9 — Spirochetal infection, unspecified, A75.0 — Epidemic louse-borne typhus fever due to Rickettsia prowazekii, A75.1 — Recrudescent typhus [Brill's disease], A75.2 — Typhus fever due to Rickettsia typhi, A75.3 — Typhus fever due to Rickettsia tsutsugamushi, A75.9 — Typhus fever, unspecified, A77.0 — Spotted fever due to Rickettsia rickettsii, A77.1 — Spotted fever due to Rickettsia conorii, A77.2 — Spotted fever due to Rickettsia siberica, A77.3 — Spotted fever due to Rickettsia australis, +235 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Pneumonia”, “Gangrene, gangrenous”, “Spirochetosis”, …; these codes share that main term but sit in a different category of the Tabular List.

A36.0 — Pharyngeal diphtheria (throat, diphtheritic), A37.01 — Whooping cough due to Bordetella pertussis with pneumonia (in, whooping cough, due to, Bordetella pertussis), A37.11 — Whooping cough due to Bordetella parapertussis with pneumonia (in, whooping cough, due to, Bordetella parapertussis), A37.81 — Whooping cough due to other Bordetella species with pneumonia (in, whooping cough, due to, specified NEC), A37.91 — Whooping cough, unspecified species with pneumonia (in, whooping cough), A42.0 — Pulmonary actinomycosis (in, actinomycosis), A43.0 — Pulmonary nocardiosis (in, nocardiosis, nocardiasis), A48.0 — Gas gangrene (gas), A50.04 — Early congenital syphilitic pneumonia (alba), A54.84 — Gonococcal pneumonia (gonococcal), A70 — Chlamydia psittaci infections (psittacosis), A78 — Q fever (in, Q fever), B01.2 — Varicella pneumonia (varicella), B05.2 — Measles complicated by pneumonia (giant cell), B06.81 — Rubella pneumonia (in, rubella), B25.0 — Cytomegaloviral pneumonitis (cytomegaloviral), B37.1 — Pulmonary candidiasis (Candida), B38.0 — Acute pulmonary coccidioidomycosis (in, coccidioidomycosis, acute), B38.1 — Chronic pulmonary coccidioidomycosis (in, coccidioidomycosis, chronic), B38.2 — Pulmonary coccidioidomycosis, unspecified (in, coccidioidomycosis), +139 more

Contextual Map

Every relationship of A69.8 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run A69.8 with these 2 related codes in Claim Check

Hierarchy

• A00-B99 — Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) (A00-B99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A65-A69 — Other spirochetal diseases[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• J15 — Bacterial pneumonia, not elsewhere classified[Excludes1]: “spirochetal pneumonia (A69.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• J17 — Pneumonia in diseases classified elsewhere[Excludes1]: “spirochetal infection NEC with pneumonia (A69.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• INF009 — Parasitic, other specified and unspecified infections[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 867 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC[MS-DRG]: “OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC (MDC 18)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 868 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC[MS-DRG]: “OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC (MDC 18)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 869 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC[MS-DRG]: “OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC (MDC 18)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 18 — Infectious and Parasitic Diseases, Systemic or Unspecified Sites[MDC crossing]: “Infectious and Parasitic Diseases, Systemic or Unspecified Sites — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries (16)

• Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), Castellani's[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), spirochetal NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Bronchospirochetosis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Bronchospirochetosis, Castellani[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Castellani's disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Disease, diseased, Castellani's[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer), lung, spirochetal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer), spirochetal NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• and 8 more

Nearest codes (10)

• A69 — Other spirochetal infections[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.0 — Necrotizing ulcerative stomatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.1 — Other Vincent's infections[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.2 — Lyme disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.20 — Lyme disease, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.21 — Meningitis due to Lyme disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.22 — Other neurologic disorders in Lyme disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• A69.23 — Arthritis due to Lyme disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 2 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to A69.8 in its code family, with their registry titles.

• A69 — Other spirochetal infections
• A69.0 — Necrotizing ulcerative stomatitis
• A69.1 — Other Vincent's infections
• A69.2 — Lyme disease
• 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
• A69.9 — Spirochetal infection, unspecified

View all codes in the A69 family