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ICD-10 Guide
ICD-10 CodesS61.359

S61.359

Billable

Open bite of unspecified finger with damage to nail

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

Code Description

ICD-10 S61.359 is a billable code used to indicate a diagnosis of open bite of unspecified finger with damage to nail.

Key Diagnostic Point:

An open bite of the finger occurs when a sharp object or animal bite penetrates the skin, resulting in a wound that exposes underlying tissues. This injury can lead to significant damage to the nail bed, which may result in nail loss or deformity. The open bite can also involve damage to the surrounding soft tissues, including tendons, nerves, and blood vessels. In cases where the injury is severe, surgical intervention may be required to repair the damaged structures and restore function. The clinical presentation may include pain, swelling, and bleeding at the site of injury, along with signs of infection such as redness and discharge. Proper assessment and management are crucial to prevent complications such as infection, scarring, or long-term functional impairment of the finger. Treatment may involve wound care, possible suturing, and in some cases, surgical procedures to repair any tendon or nerve injuries. Accurate coding of this condition is essential for appropriate reimbursement and to reflect the complexity of the injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury severity and associated complications
  • Need for detailed documentation of the extent of damage
  • Potential for co-existing injuries requiring additional codes
  • Variability in treatment approaches and surgical interventions

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to specify the finger involved
  • Lack of details regarding associated injuries
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with animal bites, sharp object injuries, or workplace accidents involving hand trauma.

Billing Considerations

Ensure that all relevant details about the injury and treatment are documented to support the coding.

Orthopedic Surgery

Documentation Requirements

Comprehensive documentation of surgical procedures performed, including any repairs to tendons or nerves.

Common Clinical Scenarios

Surgical intervention for severe open bites with tendon or nerve damage.

Billing Considerations

Document the extent of the injury and any complications that arise during surgery.

Coding Guidelines

Inclusion Criteria

Use S61.359 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code reflects the specific nature of the injury
  • Include details about the mechanism of injury and any associated complications

Exclusion Criteria

Do NOT use S61.359 When
  • Exclude codes for closed fractures or other types of injuries that do not involve an open bite

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

Ensure that the procedure is linked to the diagnosis of the open bite.

26300CPT Code

Tendon repair

Clinical Scenario

Used if tendon damage is present.

Documentation Requirements

Document the extent of tendon injury and repair performed.

Specialty Considerations

Orthopedic documentation must detail the surgical approach and findings.

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 better tracking of injury types and outcomes, leading to improved patient care and resource allocation.

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 better tracking of injury types and outcomes, leading to improved patient care and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity helps in better tracking of injury types and outcomes, leading to improved 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 an open bite and a closed bite?

An open bite involves a break in the skin with exposure of underlying tissues, while a closed bite does not penetrate the skin.