Puncture wound with foreign body of abdominal wall, unspecified quadrant with penetration into peritoneal cavity
ICD-10 S31.649 is a billable code used to indicate a diagnosis of puncture wound with foreign body of abdominal wall, unspecified quadrant with penetration into peritoneal cavity.
S31.649 describes a puncture wound of the abdominal wall that has penetrated into the peritoneal cavity, accompanied by the presence of a foreign body. This type of injury is often the result of trauma, such as a stab wound, gunshot wound, or an accidental injury from sharp objects. The peritoneal cavity is a potential space within the abdomen that houses various organs, and penetration into this area can lead to serious complications, including peritonitis, hemorrhage, and organ damage. The management of such injuries typically requires immediate surgical intervention to assess and repair any damage to internal organs, remove foreign bodies, and prevent infection. The complexity of treatment and coding arises from the need for thorough documentation of the injury's specifics, including the mechanism of injury, the type of foreign body involved, and any associated injuries to adjacent structures. Accurate coding is crucial for appropriate reimbursement and to reflect the severity of the injury in the patient's medical record.
Detailed operative reports, imaging studies, and injury assessments.
Management of stab wounds, gunshot wounds, and accidental punctures.
Documentation must include the mechanism of injury, surgical findings, and any complications.
Comprehensive patient history, physical examination findings, and initial management steps.
Initial assessment and stabilization of trauma patients with abdominal injuries.
Timely documentation is critical for accurate coding and billing.
Used when surgical intervention is required for abdominal injuries.
Operative report detailing the findings and procedures performed.
Trauma surgeons must document the extent of injury and any repairs made.
Accurate coding of S31.649 is crucial for proper reimbursement, reflecting the severity of the injury, and ensuring appropriate treatment is documented. It also aids in tracking injury patterns and outcomes in trauma care.
