Full paper found here

December, 2019

Trends and Patterns in Lyme Disease: An Analysis of Private Claims Data

A FAIR Health White Paper


Lyme disease is the nation’s predominant tick-borne disease, and it is growing. Claim lines for Lyme disease more than doubled as a percentage of all medical claim lines from 2007 to 2018.  Fair Health , an independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information found the following:

  • Lyme disease increase was more prominent in urban than rural areas.
  • Although Lyme disease is historically associated with the Northeast, North Carolina was one of the top five states in 2018 for Lyme disease claim lines as a percentage of all medical claim lines.
  • The summer months are the peak season for Lyme disease, but claim lines with Lyme disease diagnoses were submitted year round in 2018.
  • More claim lines with Lyme disease diagnoses were submitted for females than males in 2018.
  • In that year, the largest share of Lyme disease claim lines was held by individuals aged 51 to 60.
  • In 2014 and 2018, the laboratory and the office were the places of service most often used for services associated with Lyme disease patients. In 2018,the 10 most common “other diagnoses” received by patients who had been diagnosed with Lyme diseasewere all received by a greater percentage of Lyme disease patients than of the total patient population.
  • Among these were general signs and symptoms, dorsopathies (back pain), soft tissue disorders (including fibromyalgia) and other joint disorders.
  • Also in the top 10 other diagnoses for Lyme disease patients were anxiety and other nonpsychotic mental disorders, as well as mood (affective) disorders.

Much still remains unknown about Lyme disease. FAIR Health conducted this study to help fill the gap in knowledge and to provide a foundation to advance the work of other researchers.



Very interesting paper with many informative graphs, although all the data is skewed and inaccurate.  I appreciate that the authors admit that many go on to develop chronic symptoms and that the reason(s) for this are contested.

One problem; however, are the international classification of disease codes they used for the entire thing: (ICD-9-CM and ICD-10-CM) diagnostic codes reported on claims in the FAIR Health dataset, FAIR Health examined claims that were indicative of Lyme disease (e.g., ICD-9-CM 088.81, Lyme disease, and ICD-10-CM A69.2, Lyme disease, unspecified) and other tick-borne diseases (e.g., ICD-9-CM 082.0, tick-borne spotted fevers [including Rocky Mountain spotted fever], and ICD-10-CM B60.0, babesiosis).

For more on this topic:


Lyme codes are largely based on science that is rife with conflicts of interests and is globally promoted by the Infectious Diseases Society of America (IDSA). The codes also ignore many of the serious, potentially fatal complications from the disease.

While improvement is being made, these codes, when they exist at all, are far from perfect missing many patients.  This is not a new problem but a very old issue that has always been present.  Doctors can’t report things that don’t have a specific code.  Patients have been falling through the cracks for decades.

By going to the paper in the first link (above the title) you will see a pie chart showing the claims for the various tick-borne illnesses.  Please note that Bartonella didn’t even make the graph which clearly shows this chart is way off the mark.  Nearly every patient I know has Bartonella.  Why isn’t it presented?  I’ll bet there isn’t a code for it.  Also, testing is abysmal.  Only Lyme literate doctors are looking for it.

And lastly, North Carolina sticks out as one of the top 5 states in this paper for medical claims, yet this article stupidly states it’s rare there:  People in the South have been battling this misnomer since the disease was discovered.

For a lengthier read on this claims data: