Is S30.86 a billable ICD-10-CM code?

No. S30.86 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S30.86 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).

S30.86

S30.86 — Insect bite (nonvenomous) of abdomen, lower back, pelvis and external genitals

Non-billable headerICD-10-CM

S30.86 is a non-billable header ICD-10-CM code for insect bite (nonvenomous) of abdomen, lower back, pelvis and external genitals. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category S30

A: initial encounter
D: subsequent encounter
S: sequela

Excludes2 inherited from the categories above S30.86

Also inherited, and the opposite of Excludes1: these conditions are not part of S30.86, but a patient can have both, so you may code both.

Written on S30 — Superficial injury of abdomen, lower back, pelvis and external genitals

superficial injury of hip (S70.-)

Other codes that can never be billed with S30.86

These codes carry an Excludes1 note pointing at S30.86. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S30.86 alone.

S31.05Open bite of lower back and pelvis
S31.25Open bite of penis
S31.25XAOpen bite of penis, initial encounter
S31.25XDOpen bite of penis, subsequent encounter
S31.25XSOpen bite of penis, sequela
S31.35Open bite of scrotum and testes
S31.35XAOpen bite of scrotum and testes, initial encounter
S31.35XDOpen bite of scrotum and testes, subsequent encounter

Risk adjustment

S30.86 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

S30.86 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead S30.86

9 child codes. Green means billable.

Related codes at this level

Codes that share S30.8. If S30.86 is not quite right, the correct code is usually one of these.

Questions about S30.86

Is S30.86 a billable ICD-10-CM code?: No. S30.86 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S30.86 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).