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ICD-10 Guide
ICD-10 CodesS61.152

S61.152

Billable

Open bite of left thumb with damage to nail

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

Code Description

ICD-10 S61.152 is a billable code used to indicate a diagnosis of open bite of left thumb with damage to nail.

Key Diagnostic Point:

An open bite of the left thumb with damage to the nail is a specific type of injury characterized by a break in the skin and underlying tissues caused by a bite, which may be from an animal or human. This injury can lead to significant complications, including infection, damage to the nail matrix, and potential long-term functional impairment of the thumb. The open nature of the wound increases the risk of contamination and necessitates careful wound management. Clinically, patients may present with pain, swelling, and bleeding at the site of the injury, along with visible damage to the nail. Treatment often involves cleaning the wound, possible suturing, and monitoring for signs of infection. In cases where the nail matrix is damaged, surgical intervention may be required to repair the nail bed or to remove the damaged nail. Proper coding for this injury is crucial for accurate billing and to ensure appropriate treatment protocols are followed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the injury location (left thumb)
  • Inclusion of nail damage in the description
  • Potential for associated complications (infection, tendon injury)
  • Need for detailed documentation of the injury mechanism

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to note associated injuries (e.g., tendon or nerve damage)
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation regarding treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, initial assessment findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with bite wounds, lacerations, or traumatic injuries to the hand.

Billing Considerations

Ensure all relevant details are documented, including any signs of infection or complications.

Orthopedic Surgery

Documentation Requirements

Comprehensive surgical notes detailing the procedure performed, including any repairs to the nail bed or surrounding structures.

Common Clinical Scenarios

Surgical intervention for complex hand injuries, including repair of nail matrix or tendon injuries.

Billing Considerations

Document any pre-existing conditions that may affect healing or surgical outcomes.

Coding Guidelines

Inclusion Criteria

Use S61.152 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury type, location, and any associated complications
  • Include details about the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S61.152 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for initial treatment of the open bite injury.

Documentation Requirements

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

Specialty Considerations

Emergency medicine providers should ensure all details of the injury are captured.

26300CPT Code

Nail bed repair

Clinical Scenario

Used when the nail matrix is damaged and requires surgical intervention.

Documentation Requirements

Detailed surgical notes and post-operative care instructions.

Specialty Considerations

Orthopedic surgeons should document any complications during the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding injuries, such as distinguishing between open and closed bites, which aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding injuries, such as distinguishing between open and closed bites, which aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding injuries, such as distinguishing between open and closed bites, which aids in better tracking of treatment outcomes 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 an open bite and a closed bite?

An open bite involves a break in the skin and exposure of underlying tissues, while a closed bite does not break the skin and is typically less severe.