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BETA v.3.0

2025 ICD-10-CM code S00.26

Nonvenomous insect bite of the eyelid and periocular area.

Appropriate secondary codes should be used from Chapter 20 (External causes of morbidity) to specify the cause of the injury. If a foreign body is retained, an additional code from category Z18.- should be applied.Excludes notes should be carefully reviewed to prevent coding errors.

Medical necessity is established when the patient presents with symptoms consistent with a nonvenomous insect bite to the eyelid and periocular region that require medical intervention (e.g., significant swelling, infection, or allergic reaction). The treatment should be appropriate to the severity of symptoms.

Diagnosis is based on patient history and physical examination. Treatment may involve topical medications (antihistamines, antibiotics), stinger removal (if applicable), and oral medications (analgesics, antiallergics, NSAIDs).

IMPORTANT:Use additional code Z18.- for retained foreign body if applicable.Secondary codes from Chapter 20 (External causes of morbidity) should be used to indicate the cause of injury, unless the T-section code already includes the external cause.

In simple words: This code describes a sting or bite from a non-poisonous insect on your eyelid or the skin around your eye.It might cause pain, redness, swelling, or itching. Treatment usually involves over-the-counter remedies or a doctor's visit if needed.

This code represents a nonvenomous insect bite affecting the eyelid and the surrounding periocular area.It may result in pain, redness, swelling, itching, burning, tingling, or discomfort at the affected site. Diagnosis is based on patient history and physical examination. Treatment may involve topical medications (antihistamines, antibiotics), stinger removal (if applicable), and oral medications (analgesics, antiallergics, NSAIDs).

Example 1: A patient presents with a swollen eyelid and surrounding redness after being stung by a bee near the eye. The stinger is removed, and the patient is prescribed an oral antihistamine and topical antibiotic ointment., A child is bitten by a mosquito on the eyelid, resulting in localized swelling and itching.The parent applies a cold compress and gives the child an appropriate dose of children's acetaminophen for pain relief., A patient with a history of allergic reactions experiences significant swelling and difficulty opening their eye after an insect bite. They seek immediate medical attention, receiving an injection of epinephrine and observation for potential anaphylaxis.

Detailed patient history including the type of insect, time of the bite/sting, and location.Note any allergy history.Documentation of physical exam findings (erythema, edema, tenderness, etc.).Record of any treatments administered (topical/oral medications, stinger removal).Any photographic documentation of injury is beneficial.

** This code is specifically for nonvenomous insect bites. Venomous insect bites should be coded differently.The severity of the reaction can vary widely; therefore, appropriate documentation is crucial for accurate coding and reimbursement.Consider the possibility of secondary infections, which may necessitate additional coding.

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