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ICD-10 Guide
ICD-10 CodesS61.11

S61.11

Billable

Laceration without foreign body of thumb with damage to nail

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

Code Description

ICD-10 S61.11 is a billable code used to indicate a diagnosis of laceration without foreign body of thumb with damage to nail.

Key Diagnostic Point:

S61.11 refers to a specific type of injury characterized by a laceration of the thumb that does not involve a foreign body and includes damage to the nail. This condition typically arises from trauma such as cuts, bites, or accidents involving sharp objects. Clinically, it is essential to assess the extent of the laceration, including the depth and whether it has affected underlying structures such as tendons, nerves, or blood vessels. Damage to the nail can lead to complications such as nail deformity or infection. Proper evaluation often requires a thorough physical examination and may necessitate imaging studies if deeper structures are suspected to be involved. Treatment may involve wound cleaning, suturing, and possibly surgical intervention if there is significant damage to the nail bed or surrounding tissues. The prognosis is generally good with appropriate care, but complications can arise if the injury is not managed correctly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between lacerations with and without foreign bodies
  • Assessing the extent of nail damage and its implications
  • Potential involvement of underlying structures (tendons, nerves)
  • Variability in documentation practices among providers

Audit Risk Factors

  • Inadequate documentation of the injury's extent
  • Failure to specify associated injuries (e.g., tendon damage)
  • Misclassification of the injury type (e.g., laceration vs. puncture)
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the mechanism of injury, extent of damage, and treatment plan.

Common Clinical Scenarios

Patients presenting with lacerations requiring surgical repair or those with associated fractures.

Billing Considerations

Documentation should clearly outline any surgical interventions performed and the rationale for them.

Emergency Medicine

Documentation Requirements

Comprehensive assessment of the injury, including vital signs and initial treatment provided.

Common Clinical Scenarios

Patients with acute hand injuries presenting to the emergency department.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S61.11 When
  • According to ICD
  • 10 coding guidelines, S61
  • 11 should be used when the laceration is confirmed to be without foreign body involvement and includes nail damage
  • Coders must ensure that the documentation supports the diagnosis and that any associated injuries are coded appropriately

Exclusion Criteria

Do NOT use S61.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when the laceration requires simple closure without extensive repair.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons may need to provide additional details on the repair technique.

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. S61.11 provides a clear distinction for lacerations involving the thumb, enhancing clinical understanding and treatment planning.

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. S61.11 provides a clear distinction for lacerations involving the thumb, enhancing clinical understanding and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. S61.11 provides a clear distinction for lacerations involving the thumb, enhancing clinical understanding and treatment planning.

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 S61.11 and S61.12?

S61.11 is used for lacerations without foreign bodies, while S61.12 is for lacerations that involve a foreign body. Accurate documentation is crucial to determine the correct code.