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ICD-10 Guide
ICD-10 CodesS31.050

S31.050

Billable

Open bite of lower back and pelvis without penetration into retroperitoneum

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

Code Description

ICD-10 S31.050 is a billable code used to indicate a diagnosis of open bite of lower back and pelvis without penetration into retroperitoneum.

Key Diagnostic Point:

An open bite of the lower back and pelvis refers to a traumatic injury characterized by a laceration or puncture wound that does not penetrate the retroperitoneal space. This type of injury can occur due to various mechanisms, including animal bites, falls, or accidents involving sharp objects. Clinically, patients may present with localized pain, swelling, and potential signs of infection. The absence of retroperitoneal penetration is significant as it indicates that vital structures such as the kidneys, ureters, and major blood vessels remain intact. Management typically involves wound care, possible surgical intervention to repair damaged tissues, and monitoring for complications such as infection or hemorrhage. Emergency surgical interventions may be necessary if there is significant tissue damage or if the wound is contaminated. Accurate coding is essential for appropriate treatment and reimbursement, as well as for tracking injury patterns in trauma registries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Assessing the extent of tissue damage
  • Identifying associated injuries in the lumbar spine or pelvis
  • Documenting the mechanism of injury accurately

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the extent of the injury
  • Misclassification of open vs. closed injuries
  • Omission of associated injuries in the lumbar or pelvic region

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, physical examination findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with trauma from falls, animal bites, or sharp object injuries.

Billing Considerations

Ensure thorough documentation of any surgical interventions and follow-up care.

Orthopedic Surgery

Documentation Requirements

Comprehensive notes on imaging studies, surgical findings, and post-operative care.

Common Clinical Scenarios

Surgical repair of lacerations or fractures associated with pelvic or lumbar injuries.

Billing Considerations

Document any co-existing fractures or spinal injuries that may complicate treatment.

Coding Guidelines

Inclusion Criteria

Use S31.050 When
  • Follow ICD
  • CM guidelines for coding injuries, ensuring accurate documentation of the injury site, type, and any associated conditions

Exclusion Criteria

Do NOT use S31.050 When
  • Exclude codes for injuries that penetrate the retroperitoneum

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for the repair of an open bite injury requiring suturing.

Documentation Requirements

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

Specialty Considerations

Emergency medicine specialists should ensure accurate coding for wound care.

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. S31.050 provides a clear distinction for open bite injuries without retroperitoneal involvement.

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. S31.050 provides a clear distinction for open bite injuries without retroperitoneal involvement.

Reimbursement & Billing Impact

reimbursement processes. S31.050 provides a clear distinction for open bite injuries without retroperitoneal involvement.

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 retroperitoneum'?

This specification is crucial as it affects the management and potential complications of the injury. It indicates that vital structures are likely intact, which influences treatment decisions.