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ICD-10 Guide
ICD-10 CodesS81.052

S81.052

Billable

Open bite, left knee

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

Code Description

ICD-10 S81.052 is a billable code used to indicate a diagnosis of open bite, left knee.

Key Diagnostic Point:

An open bite of the left knee refers to a specific type of injury characterized by a break in the skin and underlying tissues, exposing the knee joint or surrounding structures. This injury can occur due to various mechanisms, including trauma from falls, sports injuries, or accidents. The open bite may involve damage to the skin, subcutaneous tissue, and potentially the underlying ligaments or cartilage. In the context of knee injuries, it is crucial to assess for associated injuries such as tibial or fibular fractures, ligament tears (e.g., ACL or MCL), and meniscal injuries. The management of an open bite typically involves wound care, potential surgical intervention to repair any underlying structural damage, and rehabilitation to restore function. Accurate coding is essential for proper treatment documentation and reimbursement, as well as for tracking injury patterns and outcomes in orthopedic practice.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Identifying associated fractures or ligament injuries
  • Documentation of the mechanism of injury
  • Assessment of the extent of soft tissue damage

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to document associated injuries
  • Misclassification of open vs. closed injuries
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

Fractures associated with open bites, ligament repairs, and reconstructive procedures.

Billing Considerations

Ensure clear documentation of the injury type, associated structures involved, and treatment plans.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment provided in the emergency setting.

Common Clinical Scenarios

Acute trauma cases presenting with open knee injuries requiring immediate care.

Billing Considerations

Accurate documentation of the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S81.052 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the injury type, location, and any associated conditions
  • Include details about the mechanism of injury and treatment provided

Exclusion Criteria

Do NOT use S81.052 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing for associated injuries in an open bite case.

Documentation Requirements

Document the findings from the arthroscopy and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure detailed operative notes are provided.

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, which enhances the ability to track and manage these injuries effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which enhances the ability to track and manage these injuries effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which enhances the ability to track and manage these injuries effectively.

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 penetrate the skin.