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ICD-10 Guide
ICD-10 CodesS01.451

S01.451

Billable

Open bite of right cheek and temporomandibular area

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

Code Description

ICD-10 S01.451 is a billable code used to indicate a diagnosis of open bite of right cheek and temporomandibular area.

Key Diagnostic Point:

An open bite of the right cheek and temporomandibular area refers to a laceration or puncture wound that penetrates through the skin and underlying tissues in this specific region. This type of injury can occur due to various mechanisms, including animal bites, human bites, or trauma from sharp objects. The temporomandibular area is particularly sensitive due to the presence of major nerves and blood vessels, making such injuries potentially complicated. Clinically, patients may present with pain, swelling, and difficulty in jaw movement. The risk of infection is significant, especially with bites, necessitating prompt medical evaluation and treatment. Diagnosis typically involves a thorough clinical examination and may include imaging studies to assess the extent of the injury and rule out fractures. Management often includes wound care, possible surgical intervention, and antibiotics to prevent infection. Complications can include abscess formation, scarring, and dysfunction of the temporomandibular joint (TMJ).

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential mechanisms of injury (e.g., bites, trauma)
  • Need for detailed documentation of injury specifics
  • Potential for associated injuries in the TMJ area
  • Risk of infection requiring additional coding for complications

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries or complications
  • Misclassification of the injury type (open vs. closed)
  • Lack of clarity on the treatment provided

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include the mechanism of injury, extent of the wound, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with bite wounds from animals or humans, often requiring urgent care.

Billing Considerations

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

Surgery

Documentation Requirements

Operative notes should detail the surgical approach, any repairs made, and post-operative care.

Common Clinical Scenarios

Surgical intervention for extensive lacerations or abscess drainage.

Billing Considerations

Documentation must reflect the complexity of the surgical procedure and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S01.451 When
  • Follow the ICD
  • CM guidelines for coding injuries, ensuring specificity in the location and type of injury
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S01.451 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds of the face, ears, eyelids, scalp

Clinical Scenario

Used when suturing an open bite wound on the right cheek.

Documentation Requirements

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

Specialty Considerations

Emergency and surgical specialties must 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. S01.451 provides granularity that was not available 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. S01.451 provides granularity that was not available in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. S01.451 provides granularity that was not available 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, exposing underlying tissues, while a closed bite does not penetrate the skin.