ICD-10 Y04.1XXS
Billable / SpecificAssault by human bite, sequela
About ICD-10-CM Y04.1XXS
ICD-10-CM code Y04.1XXS represents Assault by human bite, sequela. This is a billable/specific code in the External Causes of Morbidity chapter (block Y04). The 2026 edition of ICD-10-CM Y04.1XXS became effective on October 1, 2025.
Medicare LCD Coverage for Y04.1XXS
Local Coverage Determinations (LCDs) from CMS MACs that list Y04.1XXS as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Y04.1XXS.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Y04.1XXS doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Y04.1XXS
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert Y04.1XXS to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Y04.1XXS | E969 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
ICD-10 Y04.1XXS, Billing FAQ
Is ICD-10 code Y04.1XXS billable? +
Yes, Y04.1XXS is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does Y04.1XXS map to? +
Per CMS GEMs, Y04.1XXS maps to ICD-9 codes: E969. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 19, 2026.
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