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ICD-10 Guide
ICD-10 CodesS61.05

S61.05

Billable

Open bite of thumb without damage to nail

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

Code Description

ICD-10 S61.05 is a billable code used to indicate a diagnosis of open bite of thumb without damage to nail.

Key Diagnostic Point:

An open bite of the thumb without damage to the nail refers to a traumatic injury where the skin of the thumb is punctured or lacerated, typically due to a bite from another person or animal, but the nail remains intact. This type of injury can lead to significant pain, swelling, and potential complications such as infection. The thumb is a critical digit for hand function, and injuries can affect grip strength and dexterity. Treatment may involve cleaning the wound, suturing if necessary, and monitoring for signs of infection. In some cases, further intervention may be required if there is damage to underlying structures such as tendons or nerves. Proper coding is essential to ensure accurate representation of the injury for treatment and billing purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Assessing the need for additional codes for associated injuries
  • Understanding the implications of potential complications like infection
  • Documenting the absence of nail damage accurately

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to specify the absence of nail damage
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed description of the injury mechanism, treatment provided, and follow-up care.

Common Clinical Scenarios

Patients presenting with bite wounds, often requiring immediate care to prevent infection.

Billing Considerations

Ensure thorough documentation of the wound assessment and any interventions performed.

Orthopedic Surgery

Documentation Requirements

Comprehensive evaluation of potential tendon or nerve involvement, imaging results, and surgical notes if applicable.

Common Clinical Scenarios

Cases where surgical intervention is needed due to complications from the bite injury.

Billing Considerations

Document any surgical procedures performed and the rationale for intervention.

Coding Guidelines

Inclusion Criteria

Use S61.05 When
  • Follow the official ICD
  • CM coding guidelines for injuries, ensuring accurate documentation of the injury type and any associated complications
  • Include details about the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S61.05 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when the open bite requires suturing and wound care.

Documentation Requirements

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

Specialty Considerations

Emergency medicine specialists should ensure detailed notes on the injury and treatment.

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 medical records and billing. S61.05 provides a clear distinction for open bites, enhancing the understanding of treatment needs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, improving the accuracy of medical records and billing. S61.05 provides a clear distinction for open bites, enhancing the understanding of treatment needs.

Reimbursement & Billing Impact

billing. S61.05 provides a clear distinction for open bites, enhancing the understanding of treatment needs.

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 an open bite and a closed bite?

An open bite involves a break in the skin, exposing underlying tissues, while a closed bite does not break the skin and may involve bruising or swelling without an open wound.