S30.86 — Insect bite (nonvenomous) of abdomen, lower back, pelvis and external genitals
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
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 to one of these instead S30.86
9 child codes. Green means billable.
- S30.860Insect bite (nonvenomous) of lower back and pelvis
- S30.861Insect bite (nonvenomous) of abdominal wall
- S30.862Insect bite (nonvenomous) of penis
- S30.863Insect bite (nonvenomous) of scrotum and testes
- S30.864Insect bite (nonvenomous) of vagina and vulva
- S30.865Insect bite (nonvenomous) of unspecified external genital organs, male
- S30.866Insect bite (nonvenomous) of unspecified external genital organs, female
- S30.867Insect bite (nonvenomous) of anus
- S30.86AInsect bite (nonvenomous) of flank
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.
- S30.81Abrasion of abdomen, lower back, pelvis and external genitals
- S30.82Blister (nonthermal) of abdomen, lower back, pelvis and external genitals
- S30.84External constriction of abdomen, lower back, pelvis and external genitals
- S30.85Superficial foreign body of abdomen, lower back, pelvis and external genitals
- S30.87Other superficial bite of abdomen, lower back, pelvis and external genitals
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).