The provider searches for the word “tick” and in many systems, up pops W57.xxxA. Someone helpful has changed the ICD-10 definition to include the word tick, although the ICD-10 definition is “Bitten or stung by nonvenomous insect and other nonvenomous arthropods, initial encounter.”
“Insect bite of abdomen, low back, pelvis and extrn genitals” for short. S30.86 is a non-billable ICD-10 code for Insect bite (nonvenomous) of abdomen, lower back, pelvis and external genitals.
The first code should be an S code that describes the location of the bite, such as S70.362A “Insect bite (nonvenomous), left thigh, initial encounter.” So, it isn’t that it is difficult to code for a tick bite, it’s that there are two steps and the super easy, quick search leads providers astray. See more Everyday Coding Q & A’s
Whether the procedure is separately billable depends on the E/M facility guidelines you employ. If the tick requires incision to remove, use the CPT code for the site specified, if applicable, and a foreign body, subcutaneous or superficial injury tissue code for the site as well.
The first code should be an S code that describes the location of the bite, such as S70. 362A “Insect bite (nonvenomous), left thigh, initial encounter.”
2022 ICD-10-CM Diagnosis Code W57. XXXA: Bitten or stung by nonvenomous insect and other nonvenomous arthropods, initial encounter.
860A – Insect Bite (Nonvenomous) of Lower Back and Pelvis, Initial Encounter.
ICD-10-CM Code for Unspecified open wound of abdominal wall, unspecified quadrant without penetration into peritoneal cavity, initial encounter S31. 109A.
9: Fever, unspecified.
This time around, “I would code the removal as 10120 [Incision and removal of foreign body, subcutaneous tissues; simple],” says Charles, “as the provider documented that an incision was made to remove the tick.
Code W57. XXX- (A, D, or S), bitten or stung by nonvenomous insect and other nonvenomous arthropods, is an external cause code used to describe the cause of an injury or other health condition.
919.4 - Insect bite, nonvenomous, of other, multiple, and unspecified sites, without mention of infection | ICD-10-CM.
W54.0XXAICD-10-CM Code for Bitten by dog, initial encounter W54. 0XXA.
A traumatic injury or surgical incision which may be superficial or extend to intraperitoneal or extraperitoneal organs or tissues.
The types of open wounds classified in ICD-10-CM are laceration without foreign body, laceration with foreign body, puncture wound without foreign body, puncture wound with foreign body, open bite, and unspecified open wound. For instance, S81. 812A Laceration without foreign body, right lower leg, initial encounter.
ICD-10 Code for Disruption of external operation (surgical) wound, not elsewhere classified, initial encounter- T81. 31XA- Codify by AAPC.
S30.86 is a non-billable ICD-10 code for Insect bite (nonvenomous) of abdomen, lower back, pelvis and external genitals. It should not be used for HIPAA-covered transactions as a more specific code is available to choose from below.
A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.
A tick is an arthropod. But, the problem with that is, W57.xxxA is an external cause code.
So, it isn’t that it is difficult to code for a tick bite, it’s that there are two steps and the super easy, quick search leads providers astray.
A tick is an arthropod. But, the problem with that is, W57.xxxA is an external cause code. It may not be submitted in the first position on the claim form, and often it is the only code selected by the provider.
Bitten or stung by nonvenomous insect and other nonvenomous arthropods, initial encounter 1 V00-Y99#N#2021 ICD-10-CM Range V00-Y99#N#External causes of morbidity#N#Note#N#This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter 19, Injury, poisoning and certain other consequences of external causes ( S00-T88 ). Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter 20 should be used to provide additional information as to the cause of the condition.#N#External causes of morbidity 2 W50-W64#N#2021 ICD-10-CM Range W50-W64#N#Exposure to animate mechanical forces#N#Type 1 Excludes#N#Toxic effect of contact with venomous animals and plants ( T63.-)#N#Exposure to animate mechanical forces 3 W57#N#ICD-10-CM Diagnosis Code W57#N#Bitten or stung by nonvenomous insect and other nonvenomous arthropods#N#2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code#N#Type 1 Excludes#N#contact with venomous insects and arthropods ( T63.2-, T63.3-, T63.4-)#N#Bitten or stung by nonvenomous insect and other nonvenomous arthropods
W57.XXXA describes the circumstance causing an injury, not the nature of the injury. This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter ...
The 2022 edition of ICD-10-CM W57.XXXA became effective on October 1, 2021.
Depending on the payer, a location and activity at the time of injury may also be necessary. Coding for tick bites requires at least two codes: 1. Code first the location of the bite (s). In the Alphabetic Index, look up “insect” under Bite (s).
Signs and symptoms vary from no reaction to allergic symptoms such as rash, pain, irritation, and itching at the site of the bite. In severe allergy cases, difficulty breathing has been reported. Tick-borne illnesses include Lyme disease and Rocky Mountain spotted fever, as well as the lesser-known Colorado tick fever, human granulocytic anaplasmosis, human babesiosis, tularemia, and human monocytic ehrlichiosis.
To ensure the right code selection, documentation for tick bites should include the site of the bite and the cause of injury, which in this case would be “bite by a tick.”. If several bites are present, documentation should include the site of each bite. Documentation should also state if there is infection present at the site of the bite.
The provider’s notes say the bite to the neck is infected, so you’ll code for the infection, as well. In the Alphabetic Index, look up “Infection, skin (local)” to find L08.9. Verify the code in the Tabular List.
1. Code first the location of the bite (s). In the Alphabetic Index, look up “insect” under Bite (s). You are directed to “see Bite, by site, superficial, insect.”. Looking up bite, [site] leads to a five- or six-character S code.
2. External cause: W57.XXXA Bitten or stung by nonvenomous insect and other nonvenomous arthropods, initial encounter
Tick bites are often easy to spot because the tick usually attaches to the skin and may stay there for up to 10 days. They are mostly harmless, causing minor to no physical symptoms. However, there are disease-carrying ticks that can transfer diseases to humans.