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ICD-10 Guide
ICD-10 CodesS61.257

S61.257

Billable

Open bite of left little finger without damage to nail

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

Code Description

ICD-10 S61.257 is a billable code used to indicate a diagnosis of open bite of left little finger without damage to nail.

Key Diagnostic Point:

An open bite of the left little finger refers to a traumatic injury where the skin is broken, exposing underlying tissues without affecting the nail. This type of injury can occur due to various incidents, such as animal bites, human bites, or accidents involving sharp objects. Clinically, the open bite may present with swelling, pain, and potential bleeding. The absence of nail damage is significant, as it indicates that the injury is limited to the soft tissues of the finger. Proper assessment is crucial to rule out associated injuries such as fractures, tendon lacerations, or nerve damage. Treatment typically involves cleaning the wound, possibly suturing, and monitoring for infection. Rehabilitation may be necessary to restore function, especially if there is damage to the tendons or nerves. Accurate coding is essential for appropriate treatment reimbursement and tracking of hand trauma cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Assessing for associated fractures or tendon injuries
  • Documenting the extent of soft tissue damage
  • Understanding the implications of nail involvement

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to note associated injuries (e.g., fractures)
  • Misclassification of the type of bite (open vs. closed)
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the injury, treatment plan, and any surgical interventions performed.

Common Clinical Scenarios

Fractures associated with open bites, tendon repairs, and reconstructive surgeries.

Billing Considerations

Ensure that all surgical procedures are documented, including any complications or follow-up care.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Acute presentations of bite wounds, management of infections, and referrals to specialists.

Billing Considerations

Document the patient's tetanus status and any prophylactic measures taken.

Coding Guidelines

Inclusion Criteria

Use S61.257 When
  • According to ICD
  • 10 guidelines, S61
  • 257 should be used when documenting an open bite of the left little finger without nail damage
  • It is important to ensure that the documentation supports the diagnosis and that any associated injuries are coded appropriately

Exclusion Criteria

Do NOT use S61.257 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.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons may need to document any additional procedures 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 open bites. This specificity improves data collection and reimbursement accuracy for hand trauma cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity improves data collection and reimbursement accuracy for hand trauma cases.

Reimbursement & Billing Impact

reimbursement accuracy for hand trauma cases.

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 significance of documenting the absence of nail damage?

Documenting the absence of nail damage is crucial as it indicates the extent of the injury and helps differentiate it from more severe injuries that may require different treatment approaches.