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ICD-10 Guide
ICD-10 CodesS61.011

S61.011

Billable

Laceration without foreign body of right thumb without damage to nail

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/24/2025

Code Description

ICD-10 S61.011 is a billable code used to indicate a diagnosis of laceration without foreign body of right thumb without damage to nail.

Key Diagnostic Point:

S61.011 refers to a laceration of the right thumb that does not involve a foreign body and does not damage the nail. This type of injury is common in various settings, including home accidents, workplace injuries, and sports-related incidents. The laceration may vary in depth and length, potentially affecting the skin, subcutaneous tissue, and possibly underlying structures such as tendons or nerves. Accurate assessment is crucial as deeper lacerations may require surgical intervention to repair damaged structures. The absence of foreign bodies simplifies the treatment process, focusing on wound care and potential suturing. Proper documentation of the injury's characteristics, including the mechanism of injury and any associated symptoms, is essential for appropriate coding and billing. This code is particularly relevant in emergency departments and outpatient settings where immediate care is provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between lacerations and other types of injuries (e.g., abrasions, punctures)
  • Assessing the depth and extent of the laceration
  • Determining the need for surgical intervention based on the injury's severity
  • Documenting the absence of foreign bodies accurately

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the depth of the laceration
  • Misclassification of the injury type (e.g., coding as a fracture instead)
  • Omission of associated injuries (e.g., tendon or nerve damage)

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed description of the injury, mechanism of injury, and treatment provided.

Common Clinical Scenarios

Patients presenting with hand injuries from accidents, sports, or work-related incidents.

Billing Considerations

Ensure that all relevant details about the injury and treatment are documented to support coding.

Orthopedic Surgery

Documentation Requirements

Comprehensive assessment of the injury, including any surgical interventions and follow-up care.

Common Clinical Scenarios

Surgical repair of lacerations involving deeper structures or associated injuries.

Billing Considerations

Document any findings related to tendon or nerve involvement to ensure accurate coding.

Coding Guidelines

Inclusion Criteria

Use S61.011 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury's specifics
  • Include details about the mechanism of injury, treatment provided, and any associated injuries

Exclusion Criteria

Do NOT use S61.011 When
  • Exclude codes for lacerations with foreign bodies or those involving nail damage

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds of the face, ears, eyelids, scalp, neck, axillae, genitalia, trunk, and extremities

Clinical Scenario

Used when suturing a laceration on the right thumb.

Documentation Requirements

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

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of the laceration.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding lacerations, enabling better tracking of injury types and treatment outcomes. S61.011 provides a clear distinction for lacerations without foreign bodies, improving data accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding lacerations, enabling better tracking of injury types and treatment outcomes. S61.011 provides a clear distinction for lacerations without foreign bodies, improving data accuracy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding lacerations, enabling better tracking of injury types and treatment outcomes. S61.011 provides a clear distinction for lacerations without foreign bodies, improving data accuracy.

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 coding S61.011 accurately?

Accurate coding of S61.011 is crucial for proper reimbursement, tracking of injury types, and ensuring appropriate treatment protocols are followed. It helps in understanding the epidemiology of hand injuries and improving patient care.