S40.261A
S40.261A — Insect bite (nonvenomous) of right shoulder, initial encounter
Billable / specific codeICD-10-CMright
S40.261A is a billable, specific ICD-10-CM code for insect bite (nonvenomous) of right shoulder, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S40
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S40.261A 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.
Medicare coverage
S40.261A is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52438Billing and Coding: Tetanus Immunization
- A55909Billing and Coding: Wound Care
- A56459Billing and Coding: Debridement Services
- A56900Billing and Coding: Immunizations
Related codes at this level
Codes that share S40.261. If S40.261A is not quite right, the correct code is usually one of these.
Questions about S40.261A
- Is S40.261A a billable ICD-10-CM code?
- Yes. S40.261A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S40.261A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the shoulder and upper arm (S40-S49).