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ICD-10 Guide
ICD-10 CodesS31.153

S31.153

Billable

Open bite of abdominal wall, right lower quadrant without penetration into peritoneal cavity

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

Code Description

ICD-10 S31.153 is a billable code used to indicate a diagnosis of open bite of abdominal wall, right lower quadrant without penetration into peritoneal cavity.

Key Diagnostic Point:

An open bite of the abdominal wall in the right lower quadrant is a type of traumatic injury characterized by a laceration or puncture that does not penetrate the peritoneal cavity. This 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 right lower quadrant is significant as it houses vital structures such as the appendix, cecum, and portions of the small intestine. Although this injury does not involve penetration into the peritoneal cavity, it may still require careful assessment to rule out underlying organ damage. Treatment typically involves wound care, potential antibiotic therapy to prevent infection, and monitoring for any complications. Surgical intervention may be necessary if there are concerns about deeper tissue involvement or if the wound is extensive. Accurate coding is essential for proper reimbursement and to reflect the severity of the injury in the patient's medical record.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between open and closed injuries
  • Assessing the need for surgical intervention
  • Documenting the mechanism of injury accurately
  • Identifying potential complications such as infection

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document the extent of the wound
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation regarding treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed documentation of the injury mechanism, assessment findings, and treatment provided.

Common Clinical Scenarios

Patients presenting with animal bites, falls, or sharp object injuries to the abdomen.

Billing Considerations

Ensure that all relevant details about the injury and treatment are captured to support the coding.

General Surgery

Documentation Requirements

Comprehensive surgical notes detailing the procedure performed, findings, and post-operative care.

Common Clinical Scenarios

Surgical intervention for extensive abdominal wall injuries or complications arising from open bites.

Billing Considerations

Document any additional procedures performed to ensure accurate coding.

Coding Guidelines

Inclusion Criteria

Use S31.153 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the injury is documented as an open bite and that there is no evidence of peritoneal cavity involvement
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S31.153 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 an open bite wound in the right lower quadrant.

Documentation Requirements

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

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of an open bite.

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. This specificity helps in better tracking of injury types and outcomes, leading to improved patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity helps in better tracking of injury types and outcomes, leading to improved patient care and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites. This specificity helps in better tracking of injury types and outcomes, leading to improved patient care 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 is the difference between an open bite and a closed bite?

An open bite refers to a wound that is exposed and may involve the skin and underlying tissues, while a closed bite does not break the skin and may involve only soft tissue damage.