Unspecified open wound of abdominal wall, left lower quadrant without penetration into peritoneal cavity
ICD-10 S31.104 is a billable code used to indicate a diagnosis of unspecified open wound of abdominal wall, left lower quadrant without penetration into peritoneal cavity.
An unspecified open wound of the abdominal wall in the left lower quadrant indicates a traumatic injury that has resulted in a break in the skin and underlying tissues without breaching the peritoneal cavity. This type of injury can occur due to various mechanisms, including blunt trauma, penetrating injuries, or surgical complications. The left lower quadrant houses several vital structures, including parts of the colon, the left ovary in females, and the left ureter. Therefore, while the wound itself does not penetrate the peritoneum, there is a risk of associated injuries to these structures. Clinical evaluation is crucial to assess for potential complications such as internal bleeding or organ damage. Emergency surgical intervention may be required to manage the wound, especially if there are signs of infection or if the wound is extensive. Proper wound care and monitoring for signs of complications are essential in the management of these injuries.
Detailed description of the injury mechanism, assessment findings, and treatment provided.
Trauma cases from accidents, falls, or assaults presenting with abdominal wall injuries.
Ensure thorough documentation of any imaging studies or consultations that may impact coding.
Operative reports detailing the nature of the wound, surgical interventions performed, and post-operative care.
Surgical repair of abdominal wall injuries or management of complications from trauma.
Accurate coding of any additional procedures performed during surgery is essential.
Used when the open wound requires suturing without complications.
Document the size of the wound and the method of repair.
Ensure that the procedure is performed by a qualified provider.
An open wound involves a break in the skin or mucous membrane, exposing underlying tissues, while a closed wound does not break the skin and may involve bruising or internal damage.
