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ICD-10 Guide
ICD-10 CodesS61.358

S61.358

Billable

Open bite of other finger with damage to nail

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

Code Description

ICD-10 S61.358 is a billable code used to indicate a diagnosis of open bite of other finger with damage to nail.

Key Diagnostic Point:

An open bite of the finger is a type of injury characterized by a break in the skin and underlying tissues, typically resulting from a puncture or laceration caused by a sharp object or animal bite. In the case of S61.358, the injury specifically affects a finger other than the thumb, and it includes damage to the nail. This condition can lead to significant complications, including infection, loss of function, and cosmetic deformity. The nail matrix may be affected, potentially resulting in abnormal nail growth or permanent nail loss. Treatment often involves cleaning the wound, possible surgical intervention to repair damaged structures, and close monitoring for signs of infection. In cases where the injury is severe, surgical procedures such as debridement, nail bed repair, or even reconstructive surgery may be necessary to restore function and appearance. Accurate coding is essential for proper reimbursement and to reflect the complexity of the injury and treatment provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential associated injuries (e.g., fractures, tendon damage)
  • Need for detailed documentation of the extent of injury
  • Potential for surgical intervention and follow-up care
  • Variability in clinical presentation and treatment approaches

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries (e.g., fractures, tendon injuries)
  • Lack of clarity regarding the extent of nail damage
  • Inconsistent coding of follow-up visits or procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the injury mechanism, imaging results, and treatment plan.

Common Clinical Scenarios

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

Billing Considerations

Ensure all associated injuries are documented to support coding and reimbursement.

Plastic Surgery

Documentation Requirements

Comprehensive documentation of surgical procedures, including pre-operative and post-operative assessments.

Common Clinical Scenarios

Nail bed repairs, soft tissue reconstruction, and cosmetic considerations post-injury.

Billing Considerations

Focus on the aesthetic outcomes and functional restoration in documentation.

Coding Guidelines

Inclusion Criteria

Use S61.358 When
  • According to ICD
  • 10 coding guidelines, S61
  • 358 should be used when there is an open bite of a finger other than the thumb with damage to the nail
  • Coders must ensure that the documentation supports the diagnosis and reflects the severity of the injury

Exclusion Criteria

Do NOT use S61.358 When
  • Exclusions include bites that do not involve nail damage or those classified under different injury types

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 and location of the wound, as well as the repair technique used.

Specialty Considerations

Orthopedic or plastic surgery specialties may have specific protocols for documenting surgical repairs.

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 helps in capturing the complexity of injuries and their treatment, leading to better data for research and improved reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity helps in capturing the complexity of injuries and their treatment, leading to better data for research and improved reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 S61.358 and S61.357?

S61.358 refers to an open bite of a finger other than the thumb with damage to the nail, while S61.357 specifically pertains to an open bite of the thumb with similar nail damage.