2026 ICD-10-CM Diagnosis Code S40.261DInsect bite (nonvenomous) of right shoulder, subsequent encounter
S40.261D is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous) of right shoulder, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. Coders also document this condition as insect bite, nonvenomous, of shoulder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Superficial injury; contusion, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S40.261D 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.
- Insect bite, nonvenomous, of shoulder
- Nonvenomous insect bite of right shoulder with infection
- Nonvenomous insect bite of shoulder with infection
- Wound of right shoulder due to nonvenomous insect bite
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Superficial injury of shoulder and upper arm (S40). 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
Insect Bites and Stings
Most insect bites are harmless, though they sometimes cause discomfort. Bee, wasp, and hornet stings and fire ant bites usually hurt. Mosquito and flea bites usually itch. Insects can also spread diseases. In the United States, some mosquitoes spread West Nile virus.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S40.261D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S40.261DOverview
Is S40.261D (Insect bite (nonvenomous) of right shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report insect bite (nonvenomous) of right shoulder, subsequent encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character D in S40.261D mean?
The final character D marks a subsequent encounter: use it for routine care while the insect bite (nonvenomous) of right shoulder is healing, after active treatment has ended.
What MS-DRG does S40.261D group to?
When insect bite (nonvenomous) of right shoulder, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 949, 950, with relative weights from 0.6277 to 1.1897 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S40.261D 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 right shoulder, subsequent encounter on inpatient claims.
What is the ICD-9 equivalent of S40.261D?
Under the General Equivalence Mappings, insect bite (nonvenomous) of right shoulder, subsequent encounter converts to ICD-9-CM V58.89 (other specfied aftercare). 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.
