2026 ICD-10-CM Diagnosis Code S00.469SInsect bite (nonvenomous) of unspecified ear, sequela
S00.469S is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous) of unspecified ear, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 604 through 605. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S00.469S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Animal bite of ear region
- Bite wound of external ear
- Insect bite of ear region
- Nonvenomous insect bite of ear with infection
- Nonvenomous insect bite of ear without infection
- Superficial injury of ear with infection
- Superficial injury of ear without infection
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Superficial injury of head (S00). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Ear Disorders
Your ear has three main parts: outer, middle and inner. You use all of them in hearing. Sound waves come in through your outer ear. They reach your middle ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, in your middle ear.
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Convert S00.469S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S00.469SOverview
Is S00.469S (Insect bite (nonvenomous) of unspecified ear) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report insect bite (nonvenomous) of unspecified ear, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S00.469S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the insect bite (nonvenomous) of unspecified ear itself has resolved, not the original event.
What MS-DRG does S00.469S group to?
When insect bite (nonvenomous) of unspecified ear, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 604, 605, with relative weights from 0.9160 to 1.4721 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S00.469S exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for insect bite (nonvenomous) of unspecified ear, sequela on inpatient claims.
What is the ICD-9 equivalent of S00.469S?
Under the General Equivalence Mappings, insect bite (nonvenomous) of unspecified ear, sequela converts to ICD-9-CM 906.2 (late eff superficial inj). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
