S30.86AA: Insect bite (nonvenomous) of flank, initial encounter
S30.86AA, insect bite (nonvenomous) of flank, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 12 HCPCS Level II codes, including G0281 (Electrical stimulation, (unattended), to one or more…), G0329 (Electromagnetic therapy, to one or more areas for chronic…), J1670 (Injection, tetanus immune globulin, human, up to 250 units). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with S30.86AA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
| J1670 | Injection, tetanus immune globulin, human, up to 250 units | Special coverage instructions apply | — | 1 |
| G0008 | Administration of influenza virus vaccine | Carrier judgment | — | 1 |
| G0009 | Administration of pneumococcal vaccine | Carrier judgment | — | 1 |
| G0010 | Administration of hepatitis b vaccine | Carrier judgment | — | 1 |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | Special coverage instructions apply | — | 1 |
| Q2035 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) | Special coverage instructions apply | — | 1 |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | Special coverage instructions apply | — | 1 |
| Q2034 | Influenza virus vaccine, split virus, for intramuscular use (agriflu) | Special coverage instructions apply | — | 1 |
| Q2036 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) | Special coverage instructions apply | — | 1 |
| Q2039 | Influenza virus vaccine, not otherwise specified | Special coverage instructions apply | — | 1 |
Medicare policy articles listing S30.86AA
- A55909: Billing and Coding: Wound Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35125, L37166, L37228
- A52438: Billing and Coding: Tetanus Immunization (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes)
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other S30 diagnoses (Superficial injury of abdomen, lower back, pelvis and external genitals)
- S30.81AA — Abrasion of flank, initial encounter
- S30.82AA — Blister (nonthermal) of flank, initial encounter
- S30.84AA — External constriction of flank, initial encounter
- S30.85AA — Superficial foreign body of flank, initial encounter
- S30.87AA — Other superficial bite of flank, initial encounter
Frequently asked questions
Does Medicare cover S30.86AA (Insect bite (nonvenomous) of flank, initial encounter)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S30.86AA as a covered diagnosis for 12 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 S30.86AA?
The Level II codes from the policies most specific to this diagnosis are G0281 (Electrical stimulation, (unattended), to one or more…, 1 article); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 1 article); J1670 (Injection, tetanus immune globulin, human, up to 250 units, 1 article); G0008 (Administration of influenza virus vaccine, 1 article); G0009 (Administration of pneumococcal vaccine, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list S30.86AA?
A55909 (Billing and Coding: Wound Care); A52438 (Billing and Coding: Tetanus Immunization); A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines).
What is ICD-10-CM code S30.86AA?
S30.86AA is the ICD-10-CM code for insect bite (nonvenomous) of flank, initial encounter, in category S30 (Superficial injury of abdomen, lower back, pelvis and external genitals), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under G0281
- Watch G0281 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0281
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup