2026 ICD-10-CM Diagnosis Code T63.461SToxic effect of venom of wasps, accidental (unintentional), sequela
T63.461S is a billable ICD-10-CM diagnosis code for toxic effect of venom of wasps, accidental (unintentional), 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 922 through 923. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
T63.461S 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.
- Allergic reaction caused by hymenoptera venom
- Allergic reaction caused by insect bite and/or insect sting
- Allergic reaction to wasp sting
- Anaphylaxis caused by hymenoptera venom
- Anaphylaxis caused by insect bite and/or insect sting
- Anaphylaxis caused by insect venom
- Anaphylaxis caused by venom
- Hymenoptera sting
- Insect sting
- Late effect of accidental injury
- Poisoning due to sting of wasp
- Wasp sting
- Wasp sting-induced anaphylaxis
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Toxic effect of contact with venomous animals and plants (T63). 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.
Table of Drugs and ChemicalsClinical
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 T63.461S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T63.461SOverview
Is T63.461S (Toxic effect of venom of wasps, accidental (unintentional)) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report toxic effect of venom of wasps, accidental (unintentional), sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T63.461S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the toxic effect of venom of wasps, accidental (unintentional) itself has resolved, not the original event.
What MS-DRG does T63.461S group to?
When toxic effect of venom of wasps, accidental (unintentional), sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.
Is T63.461S 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 toxic effect of venom of wasps, accidental (unintentional), sequela on inpatient claims.
What is the ICD-9 equivalent of T63.461S?
Under the General Equivalence Mappings, toxic effect of venom of wasps, accidental (unintentional), sequela converts to ICD-9-CM 909.1 (late eff nonmed substanc) and E929.2 (late eff acc poisoning). 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.
