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ICD-10 Guide
ICD-10 CodesS21.92

S21.92

Billable

Laceration with foreign body of unspecified part of thorax

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/23/2025

Code Description

ICD-10 S21.92 is a billable code used to indicate a diagnosis of laceration with foreign body of unspecified part of thorax.

Key Diagnostic Point:

S21.92 refers to a laceration of the thorax that is accompanied by a foreign body, where the specific part of the thorax is not specified. This condition can arise from various traumatic incidents, including accidents, falls, or penetrating injuries. The presence of a foreign body complicates the injury, as it may lead to additional complications such as infection, hemothorax, or pneumothorax. Clinically, patients may present with chest pain, difficulty breathing, or signs of shock depending on the severity of the injury. Diagnostic imaging, such as X-rays or CT scans, may be necessary to assess the extent of the injury and the location of the foreign body. Treatment often involves surgical intervention to remove the foreign body and repair any associated damage to the thoracic structures, including the lungs, ribs, or major blood vessels. The management of such injuries requires a multidisciplinary approach, often involving trauma surgeons, pulmonologists, and critical care specialists.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of the injury site
  • Need for precise identification of foreign body type
  • Potential for associated injuries (e.g., pneumothorax, hemothorax)
  • Differentiation from similar codes for thoracic injuries

Audit Risk Factors

  • Inadequate documentation of the foreign body
  • Failure to document associated injuries
  • Misclassification of the injury site
  • Lack of clarity in operative reports

Specialty Focus

Medical Specialties

Trauma Surgery

Documentation Requirements

Detailed operative reports, imaging results, and follow-up notes are essential.

Common Clinical Scenarios

Trauma from motor vehicle accidents, falls, or gunshot wounds.

Billing Considerations

Ensure all associated injuries are documented to support coding.

Pulmonology

Documentation Requirements

Pulmonary function tests and imaging studies to assess lung involvement.

Common Clinical Scenarios

Patients presenting with respiratory distress following thoracic trauma.

Billing Considerations

Document any pulmonary complications such as pneumothorax or hemothorax.

Coding Guidelines

Inclusion Criteria

Use S21.92 When
  • According to ICD
  • 10 guidelines, S21
  • 92 should be used when a laceration with a foreign body is documented without specifying the exact location
  • Coders must ensure that the documentation supports the use of this code and that any associated injuries are also coded appropriately

Exclusion Criteria

Do NOT use S21.92 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99283CPT Code

Emergency department visit, level 3

Clinical Scenario

Used for initial evaluation of a patient with thoracic laceration.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Ensure that the visit level reflects the complexity of the case.

20103CPT Code

Removal of foreign body from thorax

Clinical Scenario

Used when surgical intervention is required to remove the foreign body.

Documentation Requirements

Detailed operative report including the type of foreign body and surgical technique used.

Specialty Considerations

Trauma surgeons must document all findings and complications.

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 with foreign bodies. S21.92 provides a clear distinction from other thoracic injuries, which aids in better tracking of trauma cases and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. S21.92 provides a clear distinction from other thoracic injuries, which aids in better tracking of trauma cases and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including those with foreign bodies. S21.92 provides a clear distinction from other thoracic injuries, which aids in better tracking of trauma cases and resource allocation.

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 should be documented to support the use of S21.92?

Documentation should include the type of laceration, the presence and type of foreign body, any associated injuries, and the treatment provided.

Can S21.92 be used for non-traumatic injuries?

No, S21.92 is specifically for traumatic lacerations with foreign bodies.