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v1.0.0
ICD-10 Guide
ICD-10 CodesS31.0

S31.0

Billable

Open wound of lower back and pelvis

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

Code Description

ICD-10 S31.0 is a billable code used to indicate a diagnosis of open wound of lower back and pelvis.

Key Diagnostic Point:

An open wound of the lower back and pelvis refers to a traumatic injury that disrupts the skin and underlying tissues in the lumbar and pelvic regions. This type of injury can result from various mechanisms, including blunt force trauma, penetrating injuries, or surgical interventions. The clinical presentation may include lacerations, abrasions, or puncture wounds, which can vary in depth and severity. Complications may arise, such as infection, hemorrhage, or damage to underlying structures, including muscles, nerves, and organs. In cases of significant trauma, associated injuries to the lumbar spine or pelvic bones may occur, necessitating comprehensive evaluation and management. Emergency surgical interventions may be required to control bleeding, repair damaged tissues, or address any injuries to the genitourinary system. Accurate coding of this condition is crucial for appropriate treatment planning and reimbursement, as well as for tracking outcomes in trauma care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential associated injuries (e.g., spinal, genitourinary)
  • Need for detailed documentation of wound characteristics
  • Potential for multiple coding based on severity and complications
  • Variability in treatment approaches and surgical interventions

Audit Risk Factors

  • Inadequate documentation of wound depth and extent
  • Failure to document associated injuries
  • Misclassification of wound type (open vs. closed)
  • Lack of clarity in surgical intervention details

Specialty Focus

Medical Specialties

Trauma Surgery

Documentation Requirements

Detailed descriptions of the wound, associated injuries, and surgical interventions performed.

Common Clinical Scenarios

Trauma patients presenting with open wounds from accidents, falls, or violence.

Billing Considerations

Ensure all associated injuries are documented to support comprehensive coding.

Urology

Documentation Requirements

Documentation of any genitourinary injuries or complications resulting from the trauma.

Common Clinical Scenarios

Patients with pelvic fractures and associated urinary tract injuries.

Billing Considerations

Collaboration with trauma surgeons to ensure accurate coding of genitourinary involvement.

Coding Guidelines

Inclusion Criteria

Use S31.0 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the wound's characteristics, associated injuries, and any surgical interventions
  • Include any relevant external cause codes to provide context for the injury

Exclusion Criteria

Do NOT use S31.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of wounds

Clinical Scenario

Used for repair of open wounds in the lower back and pelvis.

Documentation Requirements

Document the size, location, and complexity of the wound.

Specialty Considerations

Trauma surgeons should ensure accurate coding based on the extent of the repair.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of open wounds, improving the ability to capture the complexity of injuries and associated treatments, which is crucial for reimbursement and quality reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of open wounds, improving the ability to capture the complexity of injuries and associated treatments, which is crucial for reimbursement and quality reporting.

Reimbursement & Billing Impact

reimbursement and quality reporting.

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 S31.0 and S30.0?

S31.0 specifically refers to open wounds of the lower back and pelvis, while S30.0 encompasses open wounds of the abdomen, which may not include the lower back or pelvis.