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ICD-10 Guide
ICD-10 CodesS31.15

S31.15

Billable

Open bite of abdominal wall without penetration into peritoneal cavity

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

Code Description

ICD-10 S31.15 is a billable code used to indicate a diagnosis of open bite of abdominal wall without penetration into peritoneal cavity.

Key Diagnostic Point:

An open bite of the abdominal wall refers to a traumatic injury characterized by a laceration or puncture in the skin and underlying tissues of the abdomen, resulting from a bite. This injury does not penetrate the peritoneal cavity, which houses vital organs such as the intestines, liver, and spleen. Open bites can occur due to animal bites, human bites, or other traumatic incidents. Clinically, these injuries may present with localized pain, swelling, and potential signs of infection. The absence of peritoneal cavity penetration is crucial, as it significantly reduces the risk of intra-abdominal complications such as peritonitis or organ damage. Management typically involves thorough wound cleaning, possible suturing, and monitoring for infection. In cases where the bite is deep or involves significant tissue loss, surgical intervention may be necessary to ensure proper healing and function of the abdominal wall. Understanding the nature of the injury and its implications is essential for appropriate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open bites and other types of abdominal wall injuries.
  • Assessing the depth and extent of the injury for accurate coding.
  • Determining the presence or absence of peritoneal cavity involvement.
  • Documenting associated injuries or complications that may affect coding.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to specify the depth of the bite.
  • Misclassification of the injury type (bite vs. laceration).
  • Lack of follow-up documentation regarding infection or complications.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, assessment of the wound, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with animal bites, human bites, or traumatic injuries to the abdominal wall.

Billing Considerations

Ensure documentation reflects the absence of peritoneal cavity involvement and any potential complications.

General Surgery

Documentation Requirements

Comprehensive surgical notes detailing the extent of the injury, surgical interventions, and post-operative care.

Common Clinical Scenarios

Surgical repair of deep abdominal wall bites or management of complications such as abscess formation.

Billing Considerations

Document any additional procedures performed and the rationale for surgical intervention.

Coding Guidelines

Inclusion Criteria

Use S31.15 When
  • According to ICD
  • 10 coding guidelines, S31
  • 15 should be used when documenting an open bite of the abdominal wall that does not penetrate the peritoneal cavity
  • Coders must ensure that the documentation clearly indicates the nature of the injury and any associated treatments

Exclusion Criteria

Do NOT use S31.15 When
No specific exclusions found.

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 that does not require extensive surgical intervention.

Documentation Requirements

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

Specialty Considerations

Emergency medicine specialists should ensure that the repair is documented in detail.

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. This specificity aids in better tracking of injury types and outcomes, improving patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity aids in better tracking of injury types and outcomes, improving patient care and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity aids in better tracking of injury types and outcomes, improving patient care and resource allocation.

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 S31.15 and S31.16?

S31.15 refers to an open bite of the abdominal wall without penetration into the peritoneal cavity, while S31.16 indicates an open bite that does penetrate the peritoneal cavity, which carries a higher risk of complications.