S06.A1XA (Traumatic brain compression with herniation, 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).
Distinct conditions — both may be reported.
“insect bite or sting, venomous (T63.4)”
An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.
Source: CMS ICD-10-CM tabular instructional notes
Yes, when both are documented. S06.A1XA 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.
| S06.A1XATraumatic brain compression with herniation, initial encounter | T63.4Toxic effect of venom of other arthropods | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: T63.411A, T63.411D, T63.411S, T63.412A, T63.412D |
| 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 | Traumatic brain compression with herniation, initial encounter is a billable ICD-10-CM diagnosis code (S06.A1A). | 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 S06, except as noted below | The appropriate 7th character is to be added to each code from category T63 |
| Includes | traumatic brain injury injuries of ear injuries of eye injuries of face [any part] | bite or touch of venomous animal pricked or stuck by thorn or leaf |
| Use additional code | code, if applicable, to identify mild neurocognitive disorders due to known physiological condition (F06.7-) | 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) |
| Code first | the underlying traumatic brain injury, such as: diffuse traumatic brain injury (S06.2-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources