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ICD-10 Guide
ICD-10 CodesS01.152

S01.152

Billable

Open bite of left eyelid and periocular area

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

Code Description

ICD-10 S01.152 is a billable code used to indicate a diagnosis of open bite of left eyelid and periocular area.

Key Diagnostic Point:

An open bite of the left eyelid and periocular area refers to a laceration or puncture wound that penetrates the skin of the eyelid and surrounding tissues, resulting from a traumatic injury. This type of injury can occur due to various mechanisms, including animal bites, human bites, or sharp objects. The periocular area encompasses the eyelids and surrounding structures, making injuries in this region particularly concerning due to the potential for complications such as infection, scarring, and damage to the underlying ocular structures. Clinical evaluation typically involves a thorough history and physical examination, focusing on the extent of the injury, associated symptoms (e.g., bleeding, swelling, pain), and visual acuity assessment. Management may include wound cleaning, suturing, and possibly prophylactic antibiotics to prevent infection. Given the delicate nature of the eyelid and surrounding tissues, careful attention to cosmetic outcomes is essential. Complications can include delayed healing, scarring, and in severe cases, damage to the eye itself, necessitating referral to an ophthalmologist for further evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury mechanisms (e.g., bites vs. sharp objects)
  • Potential for associated ocular injuries
  • Need for detailed documentation of injury extent
  • Variability in treatment approaches based on injury severity

Audit Risk Factors

  • Inadequate documentation of injury mechanism
  • Failure to document associated ocular examination findings
  • Misclassification of the injury type (open vs. closed)
  • Lack of clarity on treatment provided

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the injury mechanism, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with animal bites, human bites, or injuries from sharp objects to the eyelid.

Billing Considerations

Consideration for potential referral to ophthalmology for further evaluation of ocular involvement.

Surgery

Documentation Requirements

Operative reports should detail the surgical approach, techniques used for wound closure, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical repair of eyelid lacerations requiring suturing or reconstructive techniques.

Billing Considerations

Documentation should emphasize cosmetic outcomes and any follow-up care required.

Coding Guidelines

Inclusion Criteria

Use S01.152 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury mechanism, location, and any associated complications
  • Use additional codes as necessary to capture any related conditions

Exclusion Criteria

Do NOT use S01.152 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

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

Clinical Scenario

Used when performing suturing of an open eyelid injury.

Documentation Requirements

Operative report detailing the repair technique and extent of the injury.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of open bite.

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 those to the eyelid and periocular area, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including those to the eyelid and periocular area, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 open and closed bites?

Open bites involve a break in the skin, exposing underlying tissues, while closed bites do not penetrate the skin.