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ICD-10 Guide
ICD-10 CodesS31.55

S31.55

Billable

Open bite of unspecified external genital organs

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

Code Description

ICD-10 S31.55 is a billable code used to indicate a diagnosis of open bite of unspecified external genital organs.

Key Diagnostic Point:

An open bite of the external genital organs refers to a traumatic injury characterized by a break in the skin and underlying tissues, resulting from a bite. This injury can occur due to various mechanisms, including animal bites, human bites, or self-inflicted injuries. The external genital organs include structures such as the penis, scrotum, vulva, and perineum. Open bites can lead to significant complications, including infection, hemorrhage, and potential damage to underlying structures. In cases of severe trauma, associated injuries may involve the abdominal cavity, pelvic region, or lumbar spine, necessitating comprehensive evaluation and management. Emergency surgical interventions may be required to address lacerations, control bleeding, and prevent infection. The management of open bites often involves wound care, possible antibiotic therapy, and surgical repair, depending on the severity and extent of the injury. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes related to these injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of injury mechanism
  • Potential for associated injuries in the pelvic region
  • Need for detailed descriptions of the wound and treatment
  • Differentiation from other types of genital injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries
  • Lack of clarity in treatment provided
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with bite wounds from animals or humans, often with associated trauma.

Billing Considerations

Ensure documentation includes any signs of infection or complications, as these can affect treatment and coding.

Urology

Documentation Requirements

Comprehensive evaluation of the injury, including imaging studies if necessary.

Common Clinical Scenarios

Management of genital injuries, including surgical repair and follow-up care.

Billing Considerations

Document any potential impact on urinary function or reproductive health.

Coding Guidelines

Inclusion Criteria

Use S31.55 When
  • According to ICD
  • 10 coding guidelines, S31
  • 55 should be used when the specific external genital organ involved is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any associated injuries are also coded appropriately

Exclusion Criteria

Do NOT use S31.55 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for repair of an open bite wound in the emergency department.

Documentation Requirements

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

Specialty Considerations

Emergency medicine providers should ensure accurate coding based on the complexity 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 injuries, including open bites, which can improve data accuracy and reimbursement processes. S31.55 provides a clear classification for unspecified genital injuries, aiding in better tracking of healthcare outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which can improve data accuracy and reimbursement processes. S31.55 provides a clear classification for unspecified genital injuries, aiding in better tracking of healthcare outcomes.

Reimbursement & Billing Impact

reimbursement processes. S31.55 provides a clear classification for unspecified genital injuries, aiding in better tracking of healthcare outcomes.

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 S31.55 and S31.54?

S31.55 is used for open bites of unspecified external genital organs, while S31.54 is specifically for open bites of male external genital organs. Accurate coding depends on the documentation of the specific injury.