2022 ICD-10-CM Code S80.869A
Insect bite (nonvenomous), unspecified lower leg, initial encounter
Code Classification
S80.869A is a billable diagnosis code used to specify a medical diagnosis of insect bite (nonvenomous), unspecified lower leg, initial encounter. The code S80.869A is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S80.869A might also be used to specify conditions or terms like insect bite to leg - nonvenomous, insect bite, nonvenomous, lower leg, nonvenomous insect bite of lower leg with infection, nonvenomous insect bite of lower leg without infection, nonvenomous insect bite of lower limb without infection , superficial injury of lower leg with infection, etc.
S80.869A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like insect bite (nonvenomous) unspecified lower leg. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
Unspecified diagnosis codes like S80.869A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Coding Guidelines
The appropriate 7th character is to be added to each code from block Superficial injury of knee and lower leg (S80). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Insect bite to leg - nonvenomous
- Insect bite, nonvenomous, lower leg
- Nonvenomous insect bite of lower leg with infection
- Nonvenomous insect bite of lower leg without infection
- Nonvenomous insect bite of lower limb without infection
- Superficial injury of lower leg with infection
- Superficial injury of lower leg without infection
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code S80.869A is grouped in the following groups for version MS-DRG V39.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2021 through 09/30/2022.
| MS-DRG | MS-DRG Title | MCD | Relative Weight |
|---|---|---|---|
| 606 | MINOR SKIN DISORDERS WITH MCC | 09 | 1.511 |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | 09 | 0.8256 |
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert S80.869A to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S80.869A its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- 916.4 - Insect bite hip & leg (Approximate Flag)
Information for Patients
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. Travelers outside the United States may be at risk for malaria and other infections.
To prevent insect bites and their complications
- Don't bother insects
- Use insect repellant
- Wear protective clothing
- Be careful when you eat outside because food attracts insects
- If you know you have severe allergic reactions to insect bites and stings (such as anaphylaxis), carry an emergency epinephrine kit
[Learn More in MedlinePlus]
Related Codes
| ICD Code | Description | Valid for Submission |
|---|---|---|
| S80 | Superficial injury of knee and lower leg | NON-BILLABLE CODE |
| S80.0 | Contusion of knee | NON-BILLABLE CODE |
| S80.00 | Contusion of unspecified knee | NON-BILLABLE CODE |
| S80.00XA | Contusion of unspecified knee, initial encounter | BILLABLE CODE |
| S80.00XD | Contusion of unspecified knee, subsequent encounter | BILLABLE CODE |
| S80.00XS | Contusion of unspecified knee, sequela | BILLABLE CODE |
| S80.01 | Contusion of right knee | NON-BILLABLE CODE |
| S80.01XA | Contusion of right knee, initial encounter | BILLABLE CODE |
| S80.01XD | Contusion of right knee, subsequent encounter | BILLABLE CODE |
| S80.01XS | Contusion of right knee, sequela | BILLABLE CODE |
| S80.02 | Contusion of left knee | NON-BILLABLE CODE |
| S80.02XA | Contusion of left knee, initial encounter | BILLABLE CODE |
| S80.02XD | Contusion of left knee, subsequent encounter | BILLABLE CODE |
| S80.02XS | Contusion of left knee, sequela | BILLABLE CODE |
| S80.1 | Contusion of lower leg | NON-BILLABLE CODE |
| S80.10 | Contusion of unspecified lower leg | NON-BILLABLE CODE |
| S80.10XA | Contusion of unspecified lower leg, initial encounter | BILLABLE CODE |
| S80.10XD | Contusion of unspecified lower leg, subsequent encounter | BILLABLE CODE |
| S80.10XS | Contusion of unspecified lower leg, sequela | BILLABLE CODE |
| S80.11 | Contusion of right lower leg | NON-BILLABLE CODE |
| S80.11XA | Contusion of right lower leg, initial encounter | BILLABLE CODE |
| S80.11XD | Contusion of right lower leg, subsequent encounter | BILLABLE CODE |
| S80.11XS | Contusion of right lower leg, sequela | BILLABLE CODE |
| S80.12 | Contusion of left lower leg | NON-BILLABLE CODE |
| S80.12XA | Contusion of left lower leg, initial encounter | BILLABLE CODE |
| S80.12XD | Contusion of left lower leg, subsequent encounter | BILLABLE CODE |
| S80.12XS | Contusion of left lower leg, sequela | BILLABLE CODE |
| S80.2 | Other superficial injuries of knee | NON-BILLABLE CODE |
| S80.21 | Abrasion of knee | NON-BILLABLE CODE |
| S80.211 | Abrasion, right knee | NON-BILLABLE CODE |
| S80.211A | Abrasion, right knee, initial encounter | BILLABLE CODE |
| S80.211D | Abrasion, right knee, subsequent encounter | BILLABLE CODE |
| S80.211S | Abrasion, right knee, sequela | BILLABLE CODE |
| S80.212 | Abrasion, left knee | NON-BILLABLE CODE |
| S80.212A | Abrasion, left knee, initial encounter | BILLABLE CODE |
| S80.212D | Abrasion, left knee, subsequent encounter | BILLABLE CODE |
| S80.212S | Abrasion, left knee, sequela | BILLABLE CODE |
| S80.219 | Abrasion, unspecified knee | NON-BILLABLE CODE |
| S80.219A | Abrasion, unspecified knee, initial encounter | BILLABLE CODE |
| S80.219D | Abrasion, unspecified knee, subsequent encounter | BILLABLE CODE |
| S80.219S | Abrasion, unspecified knee, sequela | BILLABLE CODE |
| S80.22 | Blister (nonthermal) of knee | NON-BILLABLE CODE |
| S80.221 | Blister (nonthermal), right knee | NON-BILLABLE CODE |
| S80.221A | Blister (nonthermal), right knee, initial encounter | BILLABLE CODE |
| S80.221D | Blister (nonthermal), right knee, subsequent encounter | BILLABLE CODE |
| S80.221S | Blister (nonthermal), right knee, sequela | BILLABLE CODE |
| S80.222 | Blister (nonthermal), left knee | NON-BILLABLE CODE |
| S80.222A | Blister (nonthermal), left knee, initial encounter | BILLABLE CODE |
| S80.222D | Blister (nonthermal), left knee, subsequent encounter | BILLABLE CODE |
| S80.222S | Blister (nonthermal), left knee, sequela | BILLABLE CODE |
| S80.229 | Blister (nonthermal), unspecified knee | NON-BILLABLE CODE |
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)