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ICD-10 Guide
ICD-10 CodesS61.151

S61.151

Billable

Open bite of right thumb with damage to nail

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

Code Description

ICD-10 S61.151 is a billable code used to indicate a diagnosis of open bite of right thumb with damage to nail.

Key Diagnostic Point:

An open bite of the right thumb with damage to the nail is a specific type of injury that occurs when a sharp object or another person's teeth penetrate the skin of the thumb, resulting in an open wound. This injury can lead to significant trauma not only to the skin but also to the underlying structures, including the nail bed, which may become damaged or infected. The open bite can result in pain, swelling, and potential loss of function in the thumb, which is crucial for grip and dexterity. In addition to the immediate injury, there may be complications such as tendon injuries, fractures of the phalanges, or nerve damage, particularly if the bite is deep. Proper assessment and treatment are essential to prevent long-term disability. Treatment may involve cleaning the wound, suturing if necessary, and possibly surgical intervention if there is extensive damage to the nail or underlying structures. Follow-up care is critical to monitor for signs of infection and to ensure proper healing of the nail and surrounding tissues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires detailed documentation of the injury mechanism.
  • Assessment of associated injuries (e.g., tendon, nerve, fracture).
  • Differentiation from similar codes (e.g., closed bites).
  • Potential for complications requiring additional coding.

Audit Risk Factors

  • Inadequate documentation of the injury mechanism.
  • Failure to document associated injuries.
  • Misclassification of the type of bite (open vs. closed).
  • Lack of follow-up documentation for healing and complications.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the extent of injury, imaging results, and treatment plans.

Common Clinical Scenarios

Fractures associated with open bites, tendon repairs, and surgical interventions.

Billing Considerations

Ensure documentation reflects the complexity of the injury and any surgical procedures performed.

Emergency Medicine

Documentation Requirements

Thorough assessment of the wound, including size, depth, and any foreign bodies.

Common Clinical Scenarios

Initial evaluation and management of open bites, including wound care and potential referrals.

Billing Considerations

Document all interventions performed in the emergency setting, including tetanus status and antibiotic administration.

Coding Guidelines

Inclusion Criteria

Use S61.151 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury type, location, and any associated injuries
  • Include details on the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S61.151 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for repair of the open bite wound.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should document any associated injuries.

26300CPT Code

Nail bed repair

Clinical Scenario

Used when the nail bed is damaged.

Documentation Requirements

Document the extent of nail bed damage and repair technique.

Specialty Considerations

Ensure clear documentation of the nail repair process.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, such as open bites, which enhances the ability to track and manage these injuries effectively. This specificity aids in better patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, such as open bites, which enhances the ability to track and manage these injuries effectively. This specificity aids in better patient care and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, such as open bites, which enhances the ability to track and manage these injuries effectively. This specificity aids in better patient care and resource allocation.

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 S61.151 and S61.150?

S61.151 specifies an open bite of the right thumb with damage to the nail, while S61.150 is a more general code for an open bite of an unspecified thumb. The specificity in S61.151 requires more detailed documentation regarding the injury and its treatment.