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ICD-10 Guide
ICD-10 CodesS31.155

S31.155

Billable

Open bite of abdominal wall, periumbilic region without penetration into peritoneal cavity

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

Code Description

ICD-10 S31.155 is a billable code used to indicate a diagnosis of open bite of abdominal wall, periumbilic region without penetration into peritoneal cavity.

Key Diagnostic Point:

An open bite of the abdominal wall in the periumbilical region is a type of traumatic injury characterized by a laceration or puncture that does not extend into the peritoneal cavity. This injury may occur due to various mechanisms, including animal bites, human bites, 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 differentiates this injury from more severe abdominal traumas that may involve internal organs. Management typically involves wound care, potential debridement, and monitoring for infection. Surgical intervention may be necessary if the wound is extensive or if there are complications such as abscess formation. Understanding the nature of the injury and its implications is essential for appropriate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from similar codes related to abdominal trauma
  • Need for precise documentation of the injury mechanism
  • Assessment of associated injuries in the abdominal region
  • Understanding of surgical interventions that may be required

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to note the absence of peritoneal cavity involvement
  • Misclassification of the injury severity
  • Lack of follow-up documentation regarding wound care

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with bite wounds, lacerations, or trauma to the abdominal wall.

Billing Considerations

Ensure that the documentation specifies the location and depth of the injury to avoid misclassification.

General Surgery

Documentation Requirements

Operative reports detailing the surgical intervention, if performed, and post-operative care.

Common Clinical Scenarios

Surgical repair of abdominal wall injuries, management of complications such as infections.

Billing Considerations

Accurate coding of any additional procedures performed during surgery is essential.

Coding Guidelines

Inclusion Criteria

Use S31.155 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the documentation supports the diagnosis
  • The code should be used when there is a confirmed open bite in the specified region without peritoneal involvement

Exclusion Criteria

Do NOT use S31.155 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 in the periumbilical region.

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 aids in better tracking of injury types and outcomes, which can improve 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 aids in better tracking of injury types and outcomes, which can improve 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 aids in better tracking of injury types and outcomes, which can improve 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 S31.155 and S31.154?

S31.155 refers to an open bite of the abdominal wall without penetration into the peritoneal cavity, while S31.154 indicates an open bite with such penetration, which carries a higher risk of internal injury and requires different management.