S30.867 ICD-10-CM Code: Insect bite (nonvenomous) of anus

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S30.867 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on S30.867 itself; “inherited from” names the category or block whose note applies here.

7th Character Guide

"The appropriate 7th character is to be added to each code from category S30"

• A — initial encounter
• D — subsequent encounter
• S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S30.867A, S30.867D, S30.867S

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for S30.867

MedCoder structured workflow — derived from this code’s own official record

Before you code S30.867

1. S30.867 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewS30.867A, S30.867D, S30.867S

   See the relationships section · Guide: How to choose an ICD-10-CM code →

2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. S30.867 is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

   See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

3. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1).

   Guide: 7th characters: initial, subsequent, sequela →

Choose the right path

1. Does the documentation support one of the more specific codes beneath S30.867?
   Yes → Select that code and continue the checks below on its own page.
   No → S30.867 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewS30.867A, S30.867D, S30.867S

2. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
   Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
   No → The code is invalid without its 7th character — query for the missing element.

Consider S30.867. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Anatomical site

At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.

Encounter type

Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).

External cause, place and activity

For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).

Official instructions as workflow

• Excludes2 — not part of S30.867(7 notes)

  Coding workflow: The conditions named in this note are not included in S30.867. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareS70, T18.5, T19, T63.4

  See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Bite (s) (animal) (human), anus, superficial NEC, insect

Don’t confuse S30.867 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of S30.867 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• S30.865— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Insect bite (nonvenomous) of unspecified external genital organs, male” takes S30.865; specificity in the record moves it back here.

  Full comparison: S30.867 vs S30.865 →

• S30.867A— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a initial encounter moves the case to S30.867A.

  Full comparison: S30.867 vs S30.867A →

• S30.867D— Encounter relationship (Review)

  Same underlying diagnosis, different encounter phase.

  The same diagnosis at a different phase of care; one encounter takes one 7th character.

  What moves you there: Documentation of a subsequent encounter moves the case to S30.867D.

  Full comparison: S30.867 vs S30.867D →

• S70— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of superficial injury of hip adds S70; it is not part of this code and both may be reported when both are documented.

  Full comparison: S30.867 vs S70 →

• T20— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of burns and corrosions adds T20; it is not part of this code and both may be reported when both are documented.

  Full comparison: S30.867 vs T20 →

• T32— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of burns and corrosions adds T32; it is not part of this code and both may be reported when both are documented.

  Full comparison: S30.867 vs T32 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Not billable as written — a more specific code is required: S30.867A, S30.867D, S30.867S.
• Requires a 7th character. "The appropriate 7th character is to be added to each code from category S30" Options: S30.867A, S30.867D, S30.867S

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Bite”; these codes share that main term but sit in a different category of the Tabular List.

S20.46 — Insect bite (nonvenomous) of back wall of thorax (thorax, thoracic, superficial NEC, insect, back), S20.47 — Other superficial bite of back wall of thorax (thorax, thoracic, superficial NEC, back), S20.96 — Insect bite (nonvenomous) of unspecified parts of thorax (thorax, thoracic, superficial NEC, insect), S20.97 — Other superficial bite of unspecified parts of thorax (thorax, thoracic, superficial NEC), S21.05 — Open bite of breast (breast), S21.15 — Open bite of front wall of thorax without penetration into thoracic cavity (thorax, thoracic, front), S21.25 — Open bite of back wall of thorax without penetration into thoracic cavity (thorax, thoracic, back), S21.35 — Open bite of front wall of thorax with penetration into thoracic cavity (thorax, thoracic, front, with penetration into thoracic cavity), S21.45 — Open bite of back wall of thorax with penetration into thoracic cavity (thorax, thoracic, back, with penetration into thoracic cavity), S21.95 — Open bite of unspecified part of thorax (thorax, thoracic), S31.050 — Open bite of lower back and pelvis without penetration into retroperitoneum (pelvis), S31.051 — Open bite of lower back and pelvis with penetration into retroperitoneum (pelvis, with penetration into retroperitoneal space), S31.150 — Open bite of abdominal wall, right upper quadrant without penetration into peritoneal cavity (abdomen, abdominal, wall, right, upper quadrant), S31.151 — Open bite of abdominal wall, left upper quadrant without penetration into peritoneal cavity (abdomen, abdominal, wall, left, upper quadrant), S31.152 — Open bite of abdominal wall, epigastric region without penetration into peritoneal cavity (abdomen, abdominal, wall, epigastric region), S31.153 — Open bite of abdominal wall, right lower quadrant without penetration into peritoneal cavity (abdomen, abdominal, wall, right, lower quadrant), S31.154 — Open bite of abdominal wall, left lower quadrant without penetration into peritoneal cavity (abdomen, abdominal, wall, left, lower quadrant), S31.155 — Open bite of abdominal wall, periumbilic region without penetration into peritoneal cavity (umbilical region), S31.156 — Open bite of abdominal wall, right flank without penetration into peritoneal cavity (flank, right), S31.157 — Open bite of abdominal wall, left flank without penetration into peritoneal cavity (flank, left), +123 more

Contextual Map

Every relationship of S30.867 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30-S39 — Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Index entries

• Bite (s) (animal) (human), anus, superficial NEC, insect[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

• S30 — Superficial injury of abdomen, lower back, pelvis and external genitals[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.862 — Insect bite (nonvenomous) of penis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.862A — Insect bite (nonvenomous) of penis, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.862D — Insect bite (nonvenomous) of penis, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.862S — Insect bite (nonvenomous) of penis, sequela[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.863 — Insect bite (nonvenomous) of scrotum and testes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.863A — Insect bite (nonvenomous) of scrotum and testes, initial encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• S30.863D — Insect bite (nonvenomous) of scrotum and testes, subsequent encounter[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S30.867 in its code family, with their registry titles.

• S30.865S — Insect bite (nonvenomous) of unspecified external genital organs, male, sequela
• S30.866 — Insect bite (nonvenomous) of unspecified external genital organs, female
• S30.866A — Insect bite (nonvenomous) of unspecified external genital organs, female, initial encounter
• S30.866D — Insect bite (nonvenomous) of unspecified external genital organs, female, subsequent encounter
• S30.866S — Insect bite (nonvenomous) of unspecified external genital organs, female, sequela
• S30.867A — Insect bite (nonvenomous) of anus, initial encounter
• S30.867D — Insect bite (nonvenomous) of anus, subsequent encounter
• S30.867S — Insect bite (nonvenomous) of anus, sequela
• S30.86A — Insect bite (nonvenomous) of flank
• S30.86AA — Insect bite (nonvenomous) of flank, initial encounter

View all codes in the S30 family