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ICD-10 Guide
ICD-10 CodesS61.1

S61.1

Billable

Open wound of thumb with damage to nail

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/24/2025

Code Description

ICD-10 S61.1 is a billable code used to indicate a diagnosis of open wound of thumb with damage to nail.

Key Diagnostic Point:

An open wound of the thumb with damage to the nail typically results from trauma such as cuts, lacerations, or punctures. This injury can occur in various settings, including workplaces, homes, or during sports activities. The wound may involve not only the skin but also underlying structures, including the nail bed, which can lead to complications such as infection, nail deformity, or loss of the nail. The severity of the wound can vary, ranging from superficial cuts to deep lacerations that may require surgical intervention. In cases where the nail is damaged, it is crucial to assess the extent of the injury to determine the appropriate treatment plan. This may include cleaning the wound, suturing, or even surgical repair if there is significant damage to the nail matrix or surrounding tissues. Proper documentation of the injury's mechanism, location, and extent is essential for accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying injuries (e.g., tendon, nerve, or bone involvement)
  • Need for detailed documentation of the injury mechanism and extent
  • Potential for surgical intervention and associated coding
  • Variability in treatment approaches based on injury severity

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to document associated injuries (e.g., tendon or nerve damage)
  • Incorrect coding of the wound type (e.g., open vs. closed)
  • Lack of clarity on the treatment provided

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the extent of the injury, surgical procedures performed, and post-operative care.

Common Clinical Scenarios

Repair of lacerated tendons or nerves, nail bed reconstruction.

Billing Considerations

Ensure to document any complications or additional procedures performed during surgery.

Emergency Medicine

Documentation Requirements

Thorough assessment of the wound, including size, depth, and any foreign bodies present.

Common Clinical Scenarios

Initial evaluation and treatment of traumatic thumb injuries.

Billing Considerations

Document the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S61.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the injury's specifics
  • Include details about the wound's location, depth, and any associated injuries
  • Use additional codes for complications or related conditions as necessary

Exclusion Criteria

Do NOT use S61.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for minor lacerations of the thumb requiring suturing.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons may perform more complex repairs requiring additional coding.

26300CPT Code

Nail bed repair

Clinical Scenario

Used when the nail bed is damaged and requires surgical intervention.

Documentation Requirements

Detailed notes on the extent of nail damage and repair technique.

Specialty Considerations

Ensure to document any complications or follow-up care.

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 wounds of the thumb, which enhances the ability to track and analyze treatment outcomes and resource utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open wounds of the thumb, which enhances the ability to track and analyze treatment outcomes and resource utilization.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open wounds of the thumb, which enhances the ability to track and analyze treatment outcomes and resource utilization.

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 S61.1 and S61.0?

S61.1 specifically refers to an open wound of the thumb with damage to the nail, while S61.0 refers to open wounds of other parts of the hand without specifying the thumb or nail involvement.