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v1.0.0
ICD-10 Guide
ICD-10 CodesS01.13

S01.13

Billable

Puncture wound without foreign body of eyelid and periocular area

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S01.13 is a billable code used to indicate a diagnosis of puncture wound without foreign body of eyelid and periocular area.

Key Diagnostic Point:

A puncture wound of the eyelid and periocular area is characterized by a sharp object penetrating the skin without leaving a foreign body embedded. This type of injury can occur due to various mechanisms, including accidental injuries from sharp tools, animal bites, or self-inflicted wounds. Clinically, these wounds may present with localized pain, swelling, and potential bleeding. The absence of a foreign body is crucial as it influences the management and potential complications. Diagnosis typically involves a thorough clinical examination to assess the depth of the wound, surrounding tissue involvement, and any associated injuries to the eye itself. Management may include cleaning the wound, suturing if necessary, and monitoring for signs of infection or complications such as eyelid malposition or scarring. Prompt and appropriate treatment is essential to prevent long-term sequelae, including cosmetic deformity or functional impairment of the eyelid.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between puncture wounds and lacerations
  • Assessing for associated ocular injuries
  • Documenting the absence of foreign bodies accurately
  • Understanding the implications of wound depth and location

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the absence of foreign bodies
  • Misclassification of puncture wounds as lacerations
  • Inconsistent coding of associated ocular injuries

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with puncture wounds from accidents, animal bites, or self-inflicted injuries.

Billing Considerations

Ensure that the documentation reflects the absence of foreign bodies and any potential ocular involvement.

Surgery

Documentation Requirements

Operative notes should detail the procedure performed, including any repairs or interventions.

Common Clinical Scenarios

Surgical management of complex puncture wounds requiring repair or reconstruction.

Billing Considerations

Document the surgical approach and any complications encountered during the procedure.

Coding Guidelines

Inclusion Criteria

Use S01.13 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury type, mechanism, and any associated conditions
  • Specific guidelines for external cause codes should also be adhered to

Exclusion Criteria

Do NOT use S01.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds of the face, ears, eyelids, scalp

Clinical Scenario

Used when a puncture wound requires suturing.

Documentation Requirements

Operative notes must detail the repair process.

Specialty Considerations

Emergency and surgical specialties should ensure accurate coding of the procedure.

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 puncture wounds, which enhances the accuracy of medical records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including puncture wounds, which enhances the accuracy of medical records and billing.

Reimbursement & Billing Impact

billing.

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 a puncture wound and a laceration?

A puncture wound is caused by a sharp object penetrating the skin, while a laceration involves tearing of the skin. Accurate documentation is essential to differentiate between the two for proper coding.