2026 ICD-10-CM Diagnosis Code S40.869AInsect bite (nonvenomous) of unspecified upper arm, initial encounter
S40.869A is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous) of unspecified upper arm, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 606 through 607, 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Superficial injury; contusion, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Animal bite of axilla
- Animal bite of upper arm
- Bite in axilla
- Insect bite, nonvenomous, of axilla
- Insect bite, nonvenomous, of shoulder
- Insect bite, nonvenomous, of shoulder and upper arm, infected
- Insect bite, nonvenomous, of upper arm
- Nonvenomous insect bite of axilla with infection
- Nonvenomous insect bite of axilla without infection
- Nonvenomous insect bite of shoulder with infection
- Nonvenomous insect bite of upper arm with infection
- Superficial injury of axilla with infection
- Superficial injury of axilla without infection
- Superficial injury of shoulder and upper arm
- Superficial injury of shoulder and upper arm with infection
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 S40.869A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S40.869AOverview
Is S40.869A (Insect bite (nonvenomous) of unspecified upper arm) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report insect bite (nonvenomous) of unspecified upper arm, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S40.869A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for insect bite (nonvenomous) of unspecified upper arm, such as an emergency visit or first evaluation.
What MS-DRG does S40.869A group to?
When insect bite (nonvenomous) of unspecified upper arm, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 606, 607, 963, 964, 965, with relative weights from 0.9064 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S40.869A?
Under the General Equivalence Mappings, insect bite (nonvenomous) of unspecified upper arm, initial encounter converts to ICD-9-CM 912.4 (insect bite shoulder/arm). 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.
