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ICD-10 Guide
DiagnosesAvulsion Of Toenail

Avulsion Of Toenail

ICD-10 Coding for Avulsion of Toenail(S91.209A)

PRIMARY SPECIALTYPodiatry
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Avulsion Of Toenail?
Essential facts and insights about Avulsion of Toenail

Key Clinical Considerations:

  • Pain and tenderness at the site of the toenail
  • Visible separation of the toenail from the nail bed
  • Swelling and possible bleeding around the toenail

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of trauma or injury to the toe
  • Description of the extent of avulsion and any associated injuries
  • Photographic evidence of the injury if applicable

Coding Guidelines

Usage Guidelines & Examples

  • Use S91.012A for right great toe and S91.013A for left great toe.
  • Common errors include using incorrect laterality or encounter type.

Code Exclusions

Important Exclusions

  • Nail bed lacerations without avulsion.
  • Other nail disorders such as onychomycosis or ingrown toenails.

Related ICD-10 Codes

Primary Codes
S91.012A
Avulsion of toenail, right great toe, initial encounter
S91.013A
Avulsion of toenail, left great toe, initial encounter
Differential Codes
S91.209D

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Podiatry

Specialty Applications

  • Patients with recent toe injuries, athletes, and individuals with high-risk activities.
  • Podiatry clinics, urgent care centers, and emergency departments.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document the mechanism of injury, clinical findings, and treatment provided.

Billing considerations?

Ensure accurate coding based on the specific toe affected and encounter type.