S03.41XA vs T63.4
S03.41XA (Sprain of jaw, right side, initial encounter) compared with T63.4 (Toxic effect of venom of other arthropods), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S03.41XA carries an Excludes2 note covering T63.4: “insect bite or sting, venomous (T63.4)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S03.41XASprain of jaw, right side, initial encounter | T63.4Toxic effect of venom of other arthropods | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Sprain of jaw, right side, initial encounter is a billable ICD-10-CM diagnosis code (S03.41A). | Toxic effect of venom of other arthropods is a non-billable ICD-10-CM category code (T63.4). |
| 7th character | The appropriate 7th character is to be added to each code from category S03 | The appropriate 7th character is to be added to each code from category T63 |
| Includes | avulsion of joint (capsule) or ligament of head laceration of cartilage, joint (capsule) or ligament of head sprain of cartilage, joint (capsule) or ligament of head traumatic hemarthrosis of joint or ligament of head | bite or touch of venomous animal pricked or stuck by thorn or leaf |
| Use additional code | — | code, if applicable, for anaphylactic shock (T78.2) code(s): for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources