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ICD-10 Guide
ICD-10 CodesS01.11

S01.11

Billable

Laceration without foreign body of eyelid and periocular area

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S01.11 is a billable code used to indicate a diagnosis of laceration without foreign body of eyelid and periocular area.

Key Diagnostic Point:

S01.11 refers to a laceration of the eyelid and periocular area that does not involve a foreign body. This type of injury can occur due to various mechanisms such as blunt trauma, sharp objects, or accidental injuries. The eyelid and surrounding areas are particularly vulnerable due to their anatomical structure and the presence of delicate tissues. Clinically, these lacerations may present with varying degrees of depth and may involve the skin, muscle, or even deeper structures. Symptoms typically include pain, swelling, and bleeding. The management of such injuries often requires careful assessment to determine the extent of the laceration and whether surgical intervention is necessary. Proper wound care is crucial to prevent complications such as infection, scarring, or functional impairment of the eyelid. Accurate coding is essential for appropriate reimbursement and to reflect the severity of the injury in medical records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury severity and depth
  • Potential for associated injuries (e.g., to the eye)
  • Need for precise documentation of the injury site
  • Differentiation from similar codes (e.g., lacerations with foreign bodies)

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to specify the depth of the laceration
  • Misclassification of lacerations involving foreign bodies
  • Inconsistent coding across different encounters

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation should include a detailed description of the injury, mechanism of injury, and initial treatment provided.

Common Clinical Scenarios

Patients presenting with lacerations from falls, sports injuries, or accidents.

Billing Considerations

Ensure that the mechanism of injury is clearly documented to support the diagnosis.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, extent of the laceration, and any repairs performed.

Common Clinical Scenarios

Surgical repair of eyelid lacerations requiring suturing or reconstruction.

Billing Considerations

Document any complications or additional procedures performed during surgery.

Coding Guidelines

Inclusion Criteria

Use S01.11 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the nature of the injury and any associated treatments

Exclusion Criteria

Do NOT use S01.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for simple laceration repairs in the eyelid area.

Documentation Requirements

Document the size and location of the laceration, as well as the repair technique used.

Specialty Considerations

Emergency and surgical specialties should ensure accurate coding based on the complexity of the repair.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lacerations, improving the granularity of data for injury tracking and management. S01.11 provides a clear distinction between lacerations with and without foreign bodies, enhancing clinical documentation and reimbursement accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lacerations, improving the granularity of data for injury tracking and management. S01.11 provides a clear distinction between lacerations with and without foreign bodies, enhancing clinical documentation and reimbursement accuracy.

Reimbursement & Billing Impact

reimbursement accuracy.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between S01.11 and S01.12?

S01.11 is used for lacerations without foreign bodies, while S01.12 is for lacerations that involve foreign bodies. Accurate documentation is essential to determine which code to use.