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ICD-10 Guide
ICD-10 CodesS21.32

S21.32

Billable

Laceration with foreign body of front wall of thorax with penetration into thoracic cavity

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

Code Description

ICD-10 S21.32 is a billable code used to indicate a diagnosis of laceration with foreign body of front wall of thorax with penetration into thoracic cavity.

Key Diagnostic Point:

S21.32 refers to a specific type of chest trauma characterized by a laceration of the front wall of the thorax that has been complicated by the presence of a foreign body, which has penetrated into the thoracic cavity. This condition often arises from penetrating injuries such as stab wounds or gunshot wounds, where the integrity of the thoracic wall is compromised. The penetration into the thoracic cavity can lead to serious complications, including pneumothorax (air in the pleural space), hemothorax (blood in the pleural space), and potential cardiac injuries. The presence of a foreign body can complicate surgical interventions, necessitating careful planning and execution of thoracic surgical procedures. Clinicians must assess for rib fractures, which may accompany such injuries, and evaluate the need for drainage procedures or thoracotomy to manage complications. Accurate coding of this condition is crucial for appropriate treatment planning and reimbursement, as it reflects the severity and complexity of the injury.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Presence of foreign body complicates the injury.
  • Potential for multiple associated injuries (e.g., rib fractures, pneumothorax).
  • Need for detailed documentation of the mechanism of injury.
  • Variability in surgical interventions based on injury severity.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to document associated injuries (e.g., pneumothorax, hemothorax).
  • Incorrect coding of the foreign body type or location.
  • Lack of clarity on the surgical procedures performed.

Specialty Focus

Medical Specialties

Trauma Surgery

Documentation Requirements

Detailed operative notes, imaging studies, and injury severity assessments.

Common Clinical Scenarios

Management of penetrating chest trauma, rib fractures, and associated thoracic injuries.

Billing Considerations

Ensure all associated injuries are documented to support coding for complications.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging results, and treatment provided.

Common Clinical Scenarios

Initial evaluation and stabilization of patients with penetrating chest injuries.

Billing Considerations

Accurate documentation of vital signs and interventions performed in the emergency setting.

Coding Guidelines

Inclusion Criteria

Use S21.32 When
  • According to ICD
  • 10 coding guidelines, S21
  • 32 should be used when there is a documented laceration with a foreign body that has penetrated the thoracic cavity
  • Coders must ensure that the documentation supports the diagnosis and includes details about the foreign body and any associated injuries

Exclusion Criteria

Do NOT use S21.32 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

32000CPT Code

Thoracentesis

Clinical Scenario

Used to drain fluid or air from the pleural space in cases of hemothorax or pneumothorax.

Documentation Requirements

Document the indication for the procedure, the amount of fluid drained, and the patient's response.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of S21.32.

32010CPT Code

Thoracotomy

Clinical Scenario

Performed to access the thoracic cavity for repair of lacerations and removal of foreign bodies.

Documentation Requirements

Detailed operative report outlining the procedure, findings, and any complications.

Specialty Considerations

Link the procedure to the diagnosis of S21.32 for accurate billing.

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 those with foreign bodies. S21.32 provides a clear distinction from other thoracic injuries, facilitating better tracking of trauma cases and improving the accuracy of healthcare data.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. S21.32 provides a clear distinction from other thoracic injuries, facilitating better tracking of trauma cases and improving the accuracy of healthcare data.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

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 importance of documenting the foreign body?

Documenting the foreign body is crucial as it directly impacts the coding and management of the injury. It helps in determining the complexity of the case and the necessary surgical interventions.

How do I differentiate between S21.31 and S21.32?

S21.31 is used for lacerations without foreign bodies, while S21.32 specifically requires documentation of a foreign body that has penetrated the thoracic cavity.