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ICD-10 Guide
ICD-10 CodesS01.85

S01.85

Billable

Open bite of other part of head

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

Code Description

ICD-10 S01.85 is a billable code used to indicate a diagnosis of open bite of other part of head.

Key Diagnostic Point:

An open bite of the head refers to a wound characterized by a break in the skin and underlying tissues, typically caused by a human or animal bite. This injury can occur in various locations on the head, excluding the face and neck, and may involve soft tissue damage, bleeding, and potential exposure to pathogens. Open bites can lead to complications such as infection, scarring, and in severe cases, damage to underlying structures like nerves or blood vessels. The mechanism of injury often involves a direct bite force, which can vary in severity based on the size and strength of the biter. Clinical evaluation typically includes a thorough history and physical examination, focusing on the extent of the injury, signs of infection, and the need for imaging studies if deeper structures are suspected to be involved. Management may involve wound cleaning, suturing, and prophylactic antibiotics to prevent infection. In cases where the bite is from an animal, rabies prophylaxis may also be indicated. Proper documentation of the injury's location, mechanism, and treatment is essential for accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential injury mechanisms (human vs. animal bites)
  • Need for detailed documentation of injury location and extent
  • Potential for associated complications requiring additional codes
  • Variability in clinical presentation and management

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact location of the bite
  • Omission of associated complications or co-morbidities
  • Incorrect coding of related injuries or conditions

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with open bites from dog or human attacks, requiring urgent care and potential surgical intervention.

Billing Considerations

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

Surgery

Documentation Requirements

Operative reports should detail the extent of the injury, surgical interventions performed, and post-operative care.

Common Clinical Scenarios

Surgical repair of extensive open bites requiring debridement or reconstruction.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S01.85 When
  • Follow the official ICD
  • CM coding guidelines, ensuring specificity in the documentation of the injury's location and mechanism
  • Use additional codes for complications or associated conditions as necessary

Exclusion Criteria

Do NOT use S01.85 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when suturing an open bite wound in the emergency department.

Documentation Requirements

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

Specialty Considerations

Emergency medicine providers should ensure that the repair is documented clearly to support the CPT code.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking and management of these injuries. The increased specificity can improve patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking and management of these injuries. The increased specificity can improve patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking and management of these injuries. The increased specificity can improve patient care and 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 S01.85 and S01.81?

S01.85 is specifically for open bites of other parts of the head, while S01.81 is for open bites of the face. Accurate coding depends on the precise location of the injury.