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ICD-10 Guide
ICD-10 CodesS81.019

S81.019

Billable

Laceration without foreign body, unspecified knee

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/26/2025

Code Description

ICD-10 S81.019 is a billable code used to indicate a diagnosis of laceration without foreign body, unspecified knee.

Key Diagnostic Point:

S81.019 refers to a laceration of the knee that does not involve a foreign body. This type of injury can occur due to various mechanisms, including falls, sports injuries, or accidents. The knee is a complex joint composed of bones, ligaments, tendons, and cartilage, making it susceptible to various injuries. A laceration in this area may involve the skin and underlying soft tissues, potentially affecting the knee's function. While the laceration itself may be superficial, it can lead to complications such as infection, delayed healing, or even damage to the underlying structures, including ligaments or cartilage. Proper assessment and treatment are crucial to ensure optimal recovery and prevent long-term complications. Treatment may involve cleaning the wound, suturing if necessary, and monitoring for signs of infection. Rehabilitation may also be required to restore function and strength to the knee joint.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of laceration depth and extent
  • Potential for associated injuries (e.g., ligament tears, fractures)
  • Differentiation from other knee injuries (e.g., contusions, abrasions)
  • Need for precise anatomical location specification

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to specify the depth of the laceration
  • Lack of follow-up documentation for healing progress
  • Misclassification of the injury type (e.g., coding a fracture instead)

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed description of the injury, treatment plan, and follow-up care.

Common Clinical Scenarios

Sports injuries, falls, or accidents leading to knee lacerations.

Billing Considerations

Documentation should include any associated injuries, such as ligament tears or fractures.

Emergency Medicine

Documentation Requirements

Immediate assessment findings, treatment provided, and any referrals made.

Common Clinical Scenarios

Patients presenting with acute knee injuries from trauma.

Billing Considerations

Ensure thorough documentation of the mechanism of injury and any immediate interventions.

Coding Guidelines

Inclusion Criteria

Use S81.019 When
  • According to ICD
  • 10 coding guidelines, S81
  • 019 should be used when a laceration of the knee is documented without a foreign body
  • Coders must ensure that the documentation specifies the nature of the injury and any associated conditions

Exclusion Criteria

Do NOT use S81.019 When
  • Exclusion criteria include lacerations with foreign bodies or those that are part of a more complex injury requiring different codes

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when the laceration requires suturing.

Documentation Requirements

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

Specialty Considerations

Orthopedic specialists should note any associated injuries.

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 lacerations. S81.019 provides a clear distinction for knee injuries without foreign bodies, improving data accuracy and facilitating better patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including lacerations. S81.019 provides a clear distinction for knee injuries without foreign bodies, improving data accuracy and facilitating better patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including lacerations. S81.019 provides a clear distinction for knee injuries without foreign bodies, improving data accuracy and facilitating better patient care.

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 S81.019 and S81.01X?

S81.019 is used for lacerations without foreign bodies, while S81.01X is for lacerations that involve foreign materials. Accurate documentation is essential to determine the correct code.