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v1.0.0
ICD-10 Guide
ICD-10 CodesS01.359

S01.359

Billable

Open bite of unspecified ear

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

Code Description

ICD-10 S01.359 is a billable code used to indicate a diagnosis of open bite of unspecified ear.

Key Diagnostic Point:

An open bite of the ear refers to a wound characterized by a break in the skin and underlying tissues of the ear, typically resulting from a traumatic incident such as an animal bite, human bite, or a sharp object injury. This type of injury can lead to significant bleeding, pain, and potential infection due to exposure of the underlying cartilage and soft tissue. The ear's anatomy, including its vascular supply and nerve endings, makes it particularly susceptible to complications such as hematoma formation, scarring, and cosmetic deformity. Diagnosis involves a thorough clinical examination, often supplemented by imaging studies to assess the extent of the injury and rule out associated fractures or deeper tissue damage. Management typically includes wound cleaning, possible suturing, and prophylactic antibiotics to prevent infection. In cases of severe injury, surgical intervention may be necessary to repair damaged structures and restore function and appearance.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of injury mechanism
  • Potential for multiple injuries in the same incident
  • Need for precise anatomical terminology
  • Differentiation from similar codes for other ear injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify laterality when applicable
  • Misuse of unspecified codes leading to potential denials
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the injury mechanism, initial assessment findings, and treatment provided.

Common Clinical Scenarios

Trauma cases involving animal bites or human bites, often presenting with significant swelling and pain.

Billing Considerations

Ensure that all relevant details about the injury and treatment are documented to support the use of this code.

Surgery

Documentation Requirements

Operative reports should detail the surgical approach, findings, and any repairs made to the ear structures.

Common Clinical Scenarios

Surgical intervention for severe lacerations or bites requiring reconstruction.

Billing Considerations

Accurate coding requires clear documentation of the surgical procedure and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S01.359 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the injury is confirmed and documented
  • The mechanism of injury should be clearly stated in the medical record

Exclusion Criteria

Do NOT use S01.359 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for suturing an open bite wound on the ear.

Documentation Requirements

Document the size of the wound and the method of repair.

Specialty Considerations

Emergency medicine 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 injuries, improving the accuracy of data collection and reimbursement processes. S01.359 provides a clear framework for coding open bites of the ear, which was less specific in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, improving the accuracy of data collection and reimbursement processes. S01.359 provides a clear framework for coding open bites of the ear, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. S01.359 provides a clear framework for coding open bites of the ear, which was less specific in ICD-9.

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 and underlying tissues, while a closed bite does not penetrate the skin. Open bites are more prone to infection and require different management.