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ICD-10 Guide
ICD-10 CodesS21.149

S21.149

Billable

Puncture wound with foreign body of unspecified front wall of thorax without penetration into thoracic cavity

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/23/2025

Code Description

ICD-10 S21.149 is a billable code used to indicate a diagnosis of puncture wound with foreign body of unspecified front wall of thorax without penetration into thoracic cavity.

Key Diagnostic Point:

A puncture wound with a foreign body in the front wall of the thorax refers to an injury where an object has penetrated the skin and underlying tissues of the chest wall but has not breached the thoracic cavity. This type of injury can occur due to various mechanisms, including accidents, assaults, or industrial incidents. Clinically, it is essential to assess the wound for the presence of foreign bodies, which may include fragments of metal, glass, or other materials. While the injury is localized to the chest wall, it can still lead to complications such as infection, localized hematoma, or even the development of a pneumothorax or hemothorax if the injury is severe enough to affect the pleural space. Proper evaluation and management are crucial to prevent further complications, and imaging studies may be required to ascertain the extent of the injury and the presence of any foreign objects. Treatment typically involves wound care, possible surgical intervention to remove foreign bodies, and monitoring for any signs of respiratory distress or other complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the exact location of the puncture wound
  • Identifying the type of foreign body involved
  • Assessing for potential complications such as pneumothorax or hemothorax
  • Differentiating from similar codes related to thoracic injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of foreign body
  • Lack of follow-up documentation regarding complications
  • Misclassification of the injury severity

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed description of the injury mechanism, assessment of the wound, and any imaging studies performed.

Common Clinical Scenarios

Patients presenting with stab wounds, industrial accidents, or sports-related injuries.

Billing Considerations

Ensure thorough documentation of any foreign bodies and the need for surgical intervention.

General Surgery

Documentation Requirements

Operative reports detailing the removal of foreign bodies and any associated procedures.

Common Clinical Scenarios

Surgical intervention for foreign body removal or repair of the chest wall.

Billing Considerations

Document the surgical approach and any complications encountered during the procedure.

Coding Guidelines

Inclusion Criteria

Use S21.149 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the injury's specifics, including the location and type of foreign body

Exclusion Criteria

Do NOT use S21.149 When
  • Exclude codes that indicate penetration into the thoracic cavity

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when the wound requires closure after foreign body removal.

Documentation Requirements

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

Specialty Considerations

Ensure that the procedure aligns with the injury's complexity.

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. S21.149 provides a clear distinction for injuries that do not penetrate the thoracic cavity, which is crucial for treatment and billing.

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. S21.149 provides a clear distinction for injuries that do not penetrate the thoracic cavity, which is crucial for treatment and billing.

Reimbursement & Billing Impact

reimbursement processes. S21.149 provides a clear distinction for injuries that do not penetrate the thoracic cavity, which is crucial for treatment and billing.

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 significance of specifying 'without penetration into thoracic cavity'?

This specification is crucial as it affects the management and potential complications of the injury. It helps differentiate between superficial injuries and those that may require more intensive intervention.