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ICD-10 Guide
ICD-10 CodesS01.15

S01.15

Billable

Open bite of eyelid and periocular area

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

Code Description

ICD-10 S01.15 is a billable code used to indicate a diagnosis of open bite of eyelid and periocular area.

Key Diagnostic Point:

An open bite of the eyelid and periocular area refers to a laceration or puncture wound that penetrates the skin of the eyelid or surrounding tissues, resulting in an open injury. This type of injury can occur due to various mechanisms, including animal bites, human bites, or trauma from sharp objects. The eyelid and periocular area are particularly vulnerable due to their thin skin and proximity to the eye, making such injuries potentially serious. Clinical evaluation typically involves assessing the depth of the wound, the presence of foreign bodies, and any associated injuries to the eye itself. Management may include wound cleaning, suturing, and possibly antibiotic prophylaxis to prevent infection. Given the delicate nature of the eyelid and surrounding structures, careful attention to cosmetic outcomes is also essential. Complications can include infection, scarring, and potential damage to the underlying structures, including the eye. Accurate coding is crucial for proper reimbursement and tracking of injury types.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury mechanisms (e.g., bites vs. sharp trauma)
  • Potential for associated eye injuries requiring additional coding
  • Need for precise documentation of injury depth and location
  • Differentiation from similar codes for other eyelid injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the depth of the bite or laceration
  • Misclassification of the injury type (open vs. closed)
  • Omission of associated eye injuries in coding

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation should include a detailed description of the injury, mechanism of injury, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with animal bites, human bites, or trauma from sharp objects resulting in eyelid injuries.

Billing Considerations

Consideration of potential eye involvement and the need for ophthalmology consultation.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, repair techniques used, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical repair of eyelid lacerations due to bites or trauma.

Billing Considerations

Documentation should reflect the cosmetic outcome and any follow-up care required.

Coding Guidelines

Inclusion Criteria

Use S01.15 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the nature of the injury and any associated conditions
  • Document the mechanism of injury and any relevant clinical findings

Exclusion Criteria

Do NOT use S01.15 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 performing a simple repair of an open eyelid bite.

Documentation Requirements

Document the size of the wound and the repair technique used.

Specialty Considerations

Consider the need for cosmetic repair in surgical settings.

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 of the eyelid and periocular area, improving data accuracy and facilitating better patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites of the eyelid and periocular area, improving data accuracy and facilitating better patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites of the eyelid and periocular area, improving data accuracy and facilitating better patient care tracking.

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 laceration or puncture that penetrates the skin, while a closed bite does not break the skin but may cause bruising or swelling.