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ICD-10 Guide
ICD-10 CodesS31.43

S31.43

Billable

Puncture wound without foreign body of vagina and vulva

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

Code Description

ICD-10 S31.43 is a billable code used to indicate a diagnosis of puncture wound without foreign body of vagina and vulva.

Key Diagnostic Point:

A puncture wound of the vagina and vulva is a specific type of injury characterized by a sharp object penetrating the soft tissues of the female genitalia without the presence of a foreign body. This type of injury can occur due to various mechanisms, including sexual assault, accidental injury, or during medical procedures. Clinically, these wounds may present with localized pain, bleeding, and potential risk for infection. The absence of a foreign body is significant as it influences the management and treatment approach. In cases of puncture wounds, it is crucial to assess for associated injuries, particularly in the context of abdominal trauma or pelvic injuries, as these can complicate the clinical picture. Emergency surgical interventions may be required if there is significant bleeding or if the wound involves deeper structures. Proper documentation of the mechanism of injury, the extent of the wound, and any associated injuries is essential for accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed documentation of the mechanism of injury
  • Assessment of associated injuries in the pelvic region
  • Differentiation from other types of genital injuries
  • Potential for complications such as infection or hemorrhage

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to note associated injuries or complications
  • Misclassification of the type of wound
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, vital signs, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute vaginal or vulvar injuries due to trauma or assault.

Billing Considerations

Consideration of psychological trauma and the need for sensitive handling of cases involving sexual assault.

Obstetrics and Gynecology

Documentation Requirements

Thorough documentation of the injury, including any surgical interventions and follow-up care.

Common Clinical Scenarios

Management of puncture wounds during childbirth or gynecological procedures.

Billing Considerations

Awareness of potential complications such as infection or injury to surrounding structures.

Coding Guidelines

Inclusion Criteria

Use S31.43 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the injury type, mechanism, and any associated injuries

Exclusion Criteria

Do NOT use S31.43 When
  • Exclude codes for wounds with foreign bodies or other specific conditions

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for repair of puncture wounds without complications.

Documentation Requirements

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

Specialty Considerations

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

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 for puncture wounds.

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 for puncture wounds.

Reimbursement & Billing Impact

reimbursement processes for puncture wounds.

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 S31.43 and S31.42?

S31.43 is used for puncture wounds without foreign bodies, while S31.42 is for those with foreign bodies present. Accurate documentation is essential to determine the correct code.