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ICD-10 Guide
ICD-10 CodesS11.95

S11.95

Billable

Open bite of unspecified part of neck

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

Code Description

ICD-10 S11.95 is a billable code used to indicate a diagnosis of open bite of unspecified part of neck.

Key Diagnostic Point:

An open bite of the neck refers to a laceration or puncture wound caused by a bite, which may be from an animal or human. This injury can occur in various contexts, including altercations, animal attacks, or accidents. The neck is a critical area, housing vital structures such as the trachea, esophagus, major blood vessels, and nerves. Open bites can lead to significant complications, including infection, hemorrhage, and damage to underlying structures. Clinical evaluation typically involves a thorough physical examination, imaging studies if necessary, and assessment of the wound's depth and extent. Management may include wound cleaning, suturing, and prophylactic antibiotics to prevent infection. In severe cases, surgical intervention may be required to repair damaged structures. 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 multiple injuries in a single incident
  • Differentiation between human and animal bites

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of bite (human vs. animal)
  • Lack of detail regarding associated injuries
  • Inconsistent coding of similar injuries across encounters

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed documentation of the mechanism of injury, wound assessment, and treatment provided.

Common Clinical Scenarios

Patients presenting with bite wounds from altercations or animal attacks.

Billing Considerations

Ensure accurate documentation of the type of bite and any immediate interventions performed.

Surgery

Documentation Requirements

Operative reports detailing the extent of the injury, surgical procedures performed, and postoperative care.

Common Clinical Scenarios

Surgical repair of deep neck bites involving vascular or nerve structures.

Billing Considerations

Document any complications or additional procedures performed during surgery.

Coding Guidelines

Inclusion Criteria

Use S11.95 When
  • Follow 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 S11.95 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for repair of an open bite wound on the neck.

Documentation Requirements

Document the size and depth of the wound, as well as the repair technique used.

Specialty Considerations

Emergency medicine providers should ensure accurate coding of the repair based on the complexity.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for greater specificity in coding injuries, which can improve data accuracy and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 allows for greater specificity in coding injuries, which can improve data accuracy and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 S11.95 and S11.90?

S11.95 is used for open bites of unspecified parts of the neck, while S11.90 is for unspecified open bites of the neck without further specification.