2026 ICD-10-CM Diagnosis Code S80.261AInsect bite (nonvenomous), right knee, initial encounter
S80.261A is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous), right knee, 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. Coders also document this condition as bite wound of right knee region. 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.
- Bite wound of right knee region
- Infected wound of right knee due to nonvenomous insect bite
- Insect bite, nonvenomous, of knee
- Insect bite, nonvenomous, of knee, infected
- Right knee superficial injury of skin
- Wound of right knee region due to nonvenomous insect bite
Coding GuidelinesGuidance
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 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 S80.261A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S80.261AOverview
Is S80.261A (Insect bite (nonvenomous), right knee) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report insect bite (nonvenomous), right knee, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S80.261A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for insect bite (nonvenomous), right knee, such as an emergency visit or first evaluation.
What MS-DRG does S80.261A group to?
When insect bite (nonvenomous), right knee, 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 S80.261A?
Under the General Equivalence Mappings, insect bite (nonvenomous), right knee, initial encounter converts to ICD-9-CM 916.4 (insect bite hip & leg). 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.
