S30.860A (Insect bite (nonvenomous) of lower back and pelvis, initial encounter) compared with S30.860D (Insect bite (nonvenomous) of lower back and pelvis, subsequent encounter), from the official CMS tabular data. S30.860A and S30.860D code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S30.860A and S30.860D code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| S30.860AInsect bite (nonvenomous) of lower back and pelvis, initial encounter | S30.860DInsect bite (nonvenomous) of lower back and pelvis, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| 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 | Insect bite (nonvenomous) of lower back and pelvis, initial encounter is a billable ICD-10-CM diagnosis code (S30.860A). | Insect bite (nonvenomous) of lower back and pelvis, subsequent encounter is a billable ICD-10-CM diagnosis code (S30.860D). |
| 7th character | The appropriate 7th character is to be added to each code from category S30 | The appropriate 7th character is to be added to each code from category S30 |
| Includes | injuries to the abdominal wall injuries to the anus injuries to the buttock injuries to the external genitalia | injuries to the abdominal wall injuries to the anus injuries to the buttock injuries to the external genitalia |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources