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ICD-10 Guide
ICD-10 CodesS01.42

S01.42

Billable

Laceration with foreign body of cheek and temporomandibular area

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

Code Description

ICD-10 S01.42 is a billable code used to indicate a diagnosis of laceration with foreign body of cheek and temporomandibular area.

Key Diagnostic Point:

S01.42 refers to a laceration in the cheek and temporomandibular area that is complicated by the presence of a foreign body. This type of injury typically occurs due to trauma from accidents, such as falls, sports injuries, or assaults. The foreign body may include fragments of glass, metal, or other materials that penetrate the skin and underlying tissues. Clinically, these injuries can present with pain, swelling, and potential infection. The temporomandibular joint (TMJ) is particularly sensitive, and injuries in this area can lead to complications such as restricted movement, joint dysfunction, or chronic pain. Diagnosis involves a thorough physical examination, imaging studies (like X-rays or CT scans) to assess the extent of the injury and the presence of foreign bodies, and possibly laboratory tests to rule out infection. Management typically includes cleaning the wound, removing the foreign body, and suturing the laceration. In some cases, surgical intervention may be necessary to repair deeper structures or address complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Presence of foreign body complicates the injury
  • Potential for multiple treatment modalities
  • Need for imaging studies to assess injury extent
  • Variability in documentation based on clinical presentation

Audit Risk Factors

  • Inadequate documentation of foreign body removal
  • Failure to specify the location of the laceration accurately
  • Misclassification of the injury type (e.g., coding as a simple laceration)
  • Lack of imaging documentation to support the diagnosis

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with facial trauma from accidents or assaults requiring immediate care.

Billing Considerations

Ensure that all foreign bodies are documented and that the removal process is clearly outlined.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, foreign body identification, and any repairs made.

Common Clinical Scenarios

Surgical intervention for complex lacerations involving the TMJ or surrounding structures.

Billing Considerations

Document any complications or additional procedures performed during surgery.

Coding Guidelines

Inclusion Criteria

Use S01.42 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the clinical scenario, including the presence of foreign bodies and the specific anatomical location of the injury

Exclusion Criteria

Do NOT use S01.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used when performing a simple repair of the laceration with foreign body removal.

Documentation Requirements

Document the extent of the laceration and foreign body removal.

Specialty Considerations

Emergency and surgical specialties must ensure accurate reporting 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 the differentiation of lacerations with and without foreign bodies, improving the accuracy of clinical data and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including the differentiation of lacerations with and without foreign bodies, improving the accuracy of clinical data and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 importance of documenting the foreign body?

Documenting the foreign body is crucial for accurate coding and reimbursement, as it directly affects the choice of code and the complexity of the case.