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ICD-10 Guide
ICD-10 CodesS01.459

S01.459

Billable

Open bite of unspecified cheek and temporomandibular area

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

Code Description

ICD-10 S01.459 is a billable code used to indicate a diagnosis of open bite of unspecified cheek and temporomandibular area.

Key Diagnostic Point:

An open bite of the cheek and temporomandibular area refers to a laceration or puncture wound that penetrates the skin and underlying tissues in the region of the cheek and jaw joint. This type of injury can occur due to various mechanisms, including animal bites, human bites, or trauma from sharp objects. The injury may present with swelling, pain, and bleeding, and can lead to complications such as infection or damage to the underlying structures, including nerves and blood vessels. Diagnosis typically involves a thorough clinical examination, imaging studies if necessary, and assessment of the extent of the injury. Management may include wound cleaning, suturing, and possibly antibiotics to prevent infection. In cases of significant trauma, referral to a specialist may be warranted for further evaluation and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential mechanisms of injury (e.g., bites, trauma)
  • Need for detailed documentation of injury specifics
  • Potential for associated injuries in the facial region
  • Variability in treatment approaches based on injury severity

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the extent of the injury
  • Misclassification of the injury type (e.g., open vs. closed)
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the injury mechanism, initial assessment findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with bite wounds from animals or humans, requiring immediate care.

Billing Considerations

Consideration of potential rabies exposure in animal bites and the need for tetanus prophylaxis.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any complications encountered during the procedure.

Common Clinical Scenarios

Surgical repair of complex lacerations or reconstruction of the temporomandibular joint.

Billing Considerations

Documentation should reflect the surgical necessity and any pre-existing conditions affecting the surgical outcome.

Coding Guidelines

Inclusion Criteria

Use S01.459 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the injury's specifics, including laterality and type of injury
  • Use additional codes as necessary to capture any associated conditions

Exclusion Criteria

Do NOT use S01.459 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for suturing an open bite wound in the cheek area.

Documentation Requirements

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

Specialty Considerations

Emergency medicine providers should ensure that the repair is documented as part of the acute care process.

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, which helps in better tracking and management of these injuries in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking and management of these injuries in clinical practice.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking and management of these injuries in clinical practice.

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 break in the skin with exposure of underlying tissues, while a closed bite does not penetrate the skin.