Lyme disease/Lyme borreliosis A031

Current RMA Instruments:

Changes from previous Instruments:

ICD Coding:

• ICD-10-AM Codes: A69.2

Brief description

Lyme disease is a clinical illness caused by an infection with spirochete bacteria of the Borrelia genus, transmitted through the bite of an infected tick. This condition can only be acquired from being in a geographic location where Lyme disease/Lyme borreliosis is endemic (includes the United States of America, southern Canada, the United Kingdom, Russia, Japan, and north-eastern China). Current medical evidence indicates that Lyme disease caused by the Borrelia burgdorferi sensu lato complex is not considered endemic to Australia.

Confirming the diagnosis

The diagnosis will involve clinical evaluation (symptoms and travel history) and pathology test results for confirmation. The usual method is IgM and IgG serology (by enzyme-linked immunosorbent assay or immunofluorescence antibody test) followed by a Western blot if the serology was positive. Though Borrelia culture is considered the gold standard of diagnosis, it is difficult to achieve.

To establish this diagnosis, the assessment and/or management will often require consultation with an infectious disease specialist. 

Additional diagnoses covered by SOP

• Chronic untreated Lyme disease

Conditions not covered by SOP

• Australian-acquired 'Lyme disease' #
• Lyme- like disease #
• Post-Lyme disease syndrome #
• Chronic Lyme disease #  This label is often used to refer to persistent symptoms suggestive of Lyme disease but with no evidence supporting Borrelia infection (alternative explanations/diagnoses should be explored) 

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

Clinical manifestations of Lyme disease/Lyme borreliosis include a characteristic skin rash expanding out from the site of the tick bite (erythema migrans), headache, fatigue, joint pain and swelling, heart palpitations, irregular heartbeat, nerve pain, and facial palsy. Once the diagnosis has been confirmed, clinical onset can be dated to the first presentation that is judged by the treating doctor to be related to the condition.

Clinical worsening

Lyme disease has an excellent prognosis with timely antibiotic therapy. An inability to obtain appropriate clinical management therefore can worsen this condition.