Puncture wound without foreign body of unspecified buttock
ICD-10 S31.803 is a billable code used to indicate a diagnosis of puncture wound without foreign body of unspecified buttock.
A puncture wound of the buttock is a type of injury characterized by a sharp object penetrating the skin and underlying tissues, resulting in a wound that may vary in depth and severity. This specific code, S31.803, is used when the puncture wound occurs in the buttock region and does not involve a foreign body. Such injuries can arise from various incidents, including falls, accidents, or intentional harm. Clinically, puncture wounds can lead to complications such as infection, hematoma formation, or damage to underlying structures, including muscles and nerves. In the context of abdominal trauma, pelvic injuries, and lumbar spine trauma, it is crucial to assess the extent of the injury and any associated complications. Emergency surgical interventions may be necessary if there is significant tissue damage, bleeding, or signs of infection. Proper documentation of the injury's mechanism, depth, and any treatment provided is essential for accurate coding and reimbursement.
Detailed account of the injury mechanism, assessment of vital signs, and any immediate interventions performed.
Patients presenting with puncture wounds from falls, accidents, or altercations.
Ensure that all associated injuries are documented to support the complexity of the case.
Comprehensive evaluation of the wound, imaging studies if necessary, and surgical notes if intervention is performed.
Patients requiring surgical intervention for deep puncture wounds affecting muscle or bone.
Document any potential nerve or vascular involvement to justify surgical procedures.
Used for the repair of a puncture wound in the buttock region.
Document the size of the wound and the method of repair.
Ensure that the procedure is clearly linked to the diagnosis of the puncture wound.
Document the mechanism of injury, the depth and characteristics of the wound, any associated injuries, and the treatment provided. This information is crucial for accurate coding and reimbursement.
