2026 ICD-10-CM Diagnosis Code S80.261SInsect bite (nonvenomous), right knee, sequela
S80.261S is a billable ICD-10-CM diagnosis code for insect bite (nonvenomous), right knee, 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 bite wound of right knee region. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S80.261S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the knee and lower leg (S80-S89).
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 S80.261S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S80.261SOverview
What is the ICD-10 code for insect bite (nonvenomous), right knee, sequela?
The ICD-10-CM code for insect bite (nonvenomous), right knee, sequela is S80.261S (sometimes written as S80261S). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is S80.261S (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, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S80.261S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the insect bite (nonvenomous), right knee itself has resolved, not the original event.
What MS-DRG does S80.261S group to?
When insect bite (nonvenomous), right knee, 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 S80.261S 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), right knee, sequela on inpatient claims. The code appears in the Injuries to the knee and lower leg (S80-S89) range of the CMS exempt list.
