2026 ICD-10-CM Diagnosis Code S40.261SInsect bite (nonvenomous) of right shoulder, sequela
S40.261S is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous) of right shoulder, 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. Coders also document this condition as insect bite, nonvenomous, of shoulder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S40.261S 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 S40.261S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S40.261SOverview
Is S40.261S (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, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S40.261S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the insect bite (nonvenomous) of right shoulder itself has resolved, not the original event.
What MS-DRG does S40.261S group to?
When insect bite (nonvenomous) of right shoulder, 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 S40.261S 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, sequela on inpatient claims.
What is the ICD-9 equivalent of S40.261S?
Under the General Equivalence Mappings, insect bite (nonvenomous) of right shoulder, 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.
