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ICD-10 Guide
ICD-10 CodesS01.43

S01.43

Billable

Puncture wound without foreign body of cheek and temporomandibular area

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

Code Description

ICD-10 S01.43 is a billable code used to indicate a diagnosis of puncture wound without foreign body of cheek and temporomandibular area.

Key Diagnostic Point:

A puncture wound of the cheek and temporomandibular area is characterized by a small, deep wound caused by a sharp object penetrating the skin without leaving any foreign material embedded. This type of injury can occur due to various mechanisms, including animal bites, falls, or accidents involving sharp tools. 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 physical examination and may include imaging studies if deeper structures are suspected to be involved. Management often includes wound cleaning, possible suturing, and tetanus prophylaxis, depending on the patient's vaccination status. Complications can include infection, scarring, or damage to underlying structures such as nerves or blood vessels. Proper documentation of the mechanism of injury and the absence of foreign bodies is essential for accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between puncture wounds and lacerations
  • Determining the presence or absence of foreign bodies
  • Documenting the mechanism of injury accurately
  • Understanding the anatomical specificity of the cheek and temporomandibular area

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 practices across providers

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation should include a detailed account of the injury mechanism, examination findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with puncture wounds from animal bites or sharp objects requiring immediate care.

Billing Considerations

Ensure that the documentation clearly states the absence of foreign bodies and any potential complications.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any repairs made to underlying structures.

Common Clinical Scenarios

Surgical intervention for deep puncture wounds that may involve repair of nerves or blood vessels.

Billing Considerations

Accurate coding requires clear documentation of the surgical procedure and any associated injuries.

Coding Guidelines

Inclusion Criteria

Use S01.43 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the clinical scenario and that all documentation supports the diagnosis

Exclusion Criteria

Do NOT use S01.43 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

Document the size of the wound and the method of repair.

Specialty Considerations

Emergency medicine and surgical specialties should ensure accurate linkage between the procedure and diagnosis.

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 data accuracy and improves patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including puncture wounds, which enhances data accuracy and improves patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including puncture wounds, which enhances data accuracy and improves 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 a puncture wound and a laceration?

A puncture wound is a small, deep wound caused by a sharp object penetrating the skin, while a laceration is a tear or cut in the skin that may be longer and wider.