Patient presented with rash and on exam provider noted scattered erythematous papules with central punctum then reported an external cause code (W) to indicate it was from an insect bite. My question is, since there’s no documentation that indicates patient got bit by a bug but the exam findings would infer a bug bite should we still report the primary S code or report the sign & symptom as rash & include the exam findings as additional diagnosis codes? Any help would be great!