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ICD-10 Guide
ICD-10 CodesS31.151

S31.151

Billable

Open bite of abdominal wall, left upper quadrant without penetration into peritoneal cavity

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

Code Description

ICD-10 S31.151 is a billable code used to indicate a diagnosis of open bite of abdominal wall, left upper quadrant without penetration into peritoneal cavity.

Key Diagnostic Point:

An open bite of the abdominal wall in the left upper quadrant refers to a traumatic injury characterized by a laceration or puncture wound that does not extend into the peritoneal cavity. This type of injury can occur due to various mechanisms, including animal bites, falls, or sharp object injuries. Clinically, patients may present with localized pain, swelling, and potential signs of infection. The absence of peritoneal cavity penetration is crucial as it indicates that the internal organs, such as the spleen or stomach, are not directly involved, which can significantly affect treatment and prognosis. Management typically involves wound care, possible debridement, and monitoring for infection. Surgical intervention may be necessary if there are complications or if the wound is extensive. Accurate coding is essential for appropriate treatment reimbursement and to reflect the severity of the injury in medical records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Determining the extent of the injury and involvement of surrounding structures
  • Assessing for potential complications such as infection
  • Understanding the anatomical location and its implications for treatment

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the location of the injury accurately
  • Lack of follow-up documentation regarding wound healing
  • Misclassification of the injury type (open vs. closed)

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, examination findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with trauma from animal bites or sharp objects.

Billing Considerations

Ensure that the documentation reflects the absence of peritoneal cavity involvement.

General Surgery

Documentation Requirements

Operative reports detailing any surgical interventions, wound care protocols, and follow-up assessments.

Common Clinical Scenarios

Surgical intervention for extensive lacerations or complications arising from the injury.

Billing Considerations

Document any potential complications that may arise from the injury.

Coding Guidelines

Inclusion Criteria

Use S31.151 When
  • According to ICD
  • 10 guidelines, this code should be used when the injury is specifically an open bite without penetration into the peritoneal cavity
  • Coders must ensure that the documentation supports the diagnosis and that there are no signs of internal organ involvement

Exclusion Criteria

Do NOT use S31.151 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for the repair of the open bite injury in the left upper quadrant.

Documentation Requirements

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

Specialty Considerations

Ensure that the procedure aligns with the diagnosis and that the injury is accurately described.

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 of trauma cases and outcomes. This specificity aids in research and quality improvement initiatives.

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 of trauma cases and outcomes. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which helps in better tracking of trauma cases and outcomes. This specificity aids in research and quality improvement initiatives.

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 injury?

An open bite involves a break in the skin with exposure to the external environment, while a closed injury does not penetrate the skin. Open bites may have a higher risk of infection and require different management.