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ICD-10 Guide
ICD-10 CodesS01.159

S01.159

Billable

Open bite of unspecified eyelid and periocular area

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

Code Description

ICD-10 S01.159 is a billable code used to indicate a diagnosis of open bite of unspecified eyelid and periocular area.

Key Diagnostic Point:

An open bite of the eyelid and periocular area refers to a laceration or puncture wound resulting from a bite, which can occur due to animal bites, human bites, or self-inflicted injuries. This type of injury can lead to significant soft tissue damage, potential bleeding, and risk of infection. The eyelid and surrounding areas are particularly vulnerable due to their thin skin and proximity to the eye, making timely and appropriate management crucial. Clinical evaluation typically includes a thorough history of the incident, physical examination to assess the extent of the injury, and possibly imaging studies if deeper structures are involved. Management may involve wound cleaning, suturing, and prophylactic antibiotics to prevent infection. In cases of significant tissue loss or functional impairment, surgical intervention may be necessary. Complications can include scarring, functional impairment of eyelid movement, and vision problems if the eye is involved. Accurate coding is essential for proper reimbursement and tracking of injury patterns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of bite injuries
  • Need for specificity in the location of the injury
  • Potential for associated injuries requiring additional codes
  • Differentiation between open and closed injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of bite (animal vs. human)
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the injury mechanism, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with bite wounds from pets, human bites during altercations, or self-inflicted injuries.

Billing Considerations

Consideration of rabies prophylaxis in animal bites and the need for tetanus updates.

Surgery

Documentation Requirements

Operative reports should detail the extent of the injury, surgical techniques used, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical repair of extensive eyelid lacerations or reconstruction following significant tissue loss.

Billing Considerations

Documentation must reflect the complexity of the surgical procedure and any additional procedures performed.

Coding Guidelines

Inclusion Criteria

Use S01.159 When
  • Follow the ICD
  • CM guidelines for coding injuries, ensuring specificity in the location and type of injury
  • Use additional codes as necessary to capture any associated complications or conditions

Exclusion Criteria

Do NOT use S01.159 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for suturing open bite injuries of the eyelid.

Documentation Requirements

Document the size of the wound and the technique used.

Specialty Considerations

Emergency medicine and surgical specialties may have different documentation needs.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding injuries, including open bites, which can improve data collection and analysis for injury prevention and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding injuries, including open bites, which can improve data collection and analysis for injury prevention and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding injuries, including open bites, which can improve data collection and analysis for injury prevention and treatment outcomes.

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 an open bite and a closed bite?

An open bite involves a break in the skin with exposure of underlying tissues, while a closed bite does not penetrate the skin.