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ICD-10 Guide
ICD-10 CodesS61.149

S61.149

Billable

Puncture wound with foreign body of unspecified thumb with damage to nail

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

Code Description

ICD-10 S61.149 is a billable code used to indicate a diagnosis of puncture wound with foreign body of unspecified thumb with damage to nail.

Key Diagnostic Point:

A puncture wound with a foreign body in the thumb is a specific type of injury that occurs when a sharp object penetrates the skin, potentially introducing foreign material into the wound. This injury can lead to complications such as infection, damage to underlying structures, and nail bed injury. The thumb, being a critical digit for hand function, is particularly susceptible to such injuries. Damage to the nail may result in nail deformity or loss, and if the foreign body is not removed, it can lead to chronic pain or infection. Clinicians must assess for associated injuries, including fractures of the phalanges, tendon injuries, or nerve damage, which may require surgical intervention. Proper wound care and follow-up are essential to ensure healing and restore function. The complexity of this injury lies in the potential for multiple associated injuries and the need for thorough documentation to capture the full extent of the injury and treatment provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Potential for associated fractures or tendon injuries
  • Need for detailed documentation of foreign body removal
  • Variability in treatment approaches based on injury severity
  • Assessment of nail damage and potential surgical intervention

Audit Risk Factors

  • Inadequate documentation of the foreign body and its removal
  • Failure to document associated injuries such as fractures or tendon damage
  • Incorrect coding of the nail damage severity
  • Lack of follow-up documentation on healing and complications

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes including the type of foreign body, method of removal, and any associated repairs.

Common Clinical Scenarios

Injuries from industrial accidents, sports injuries, or household accidents involving sharp objects.

Billing Considerations

Ensure to document any nerve or tendon repair performed during surgery.

Emergency Medicine

Documentation Requirements

Comprehensive assessment notes including mechanism of injury, initial treatment, and follow-up care.

Common Clinical Scenarios

Patients presenting with puncture wounds from nails, glass, or other sharp objects.

Billing Considerations

Document tetanus status and any prophylactic measures taken.

Coding Guidelines

Inclusion Criteria

Use S61.149 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the injury's specifics, including the presence of a foreign body and any associated injuries

Exclusion Criteria

Do NOT use S61.149 When
  • Exclude codes for simple lacerations or contusions without foreign body involvement

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when the wound requires closure after foreign body removal.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons may need to document any additional repairs performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. This specificity aids in better tracking of injury types and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. This specificity aids in better tracking of injury types and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. This specificity aids in better tracking of injury types and treatment outcomes.

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 should be documented for a puncture wound with foreign body?

Document the mechanism of injury, type of foreign body, location of the wound, any associated injuries, and the treatment provided, including foreign body removal and wound care.