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ICD-10 Guide
ICD-10 CodesS61.12

S61.12

Billable

Laceration with foreign body of thumb with damage to nail

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

Code Description

ICD-10 S61.12 is a billable code used to indicate a diagnosis of laceration with foreign body of thumb with damage to nail.

Key Diagnostic Point:

S61.12 refers to a specific type of injury characterized by a laceration of the thumb that includes the presence of a foreign body and damage to the nail. This condition often arises from accidents involving sharp objects, machinery, or falls. The laceration may penetrate through the skin and into deeper structures, potentially affecting tendons, nerves, and blood vessels. The presence of a foreign body complicates the injury, as it may require surgical intervention for removal. Damage to the nail can lead to complications such as nail deformity or loss, necessitating careful management. Clinicians must assess the extent of the injury, including any associated fractures or tendon injuries, and determine the appropriate treatment, which may involve suturing, foreign body removal, and possibly hand surgery. Accurate coding is essential for proper reimbursement and to reflect the complexity of the injury in the patient's medical record.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Presence of foreign body complicates the injury management.
  • Potential for associated injuries such as tendon or nerve damage.
  • Need for detailed documentation of the injury's extent and treatment.
  • Variability in treatment approaches based on the injury's severity.

Audit Risk Factors

  • Inadequate documentation of the foreign body and its removal.
  • Failure to document associated injuries (e.g., tendon or nerve damage).
  • Incorrect coding of the injury severity or treatment performed.
  • Lack of clarity in the clinical notes regarding the extent of nail damage.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes describing the laceration, foreign body removal, and any repairs performed.

Common Clinical Scenarios

Injuries from machinery, sports-related injuries, or falls leading to complex hand trauma.

Billing Considerations

Ensure all associated injuries are documented, including any fractures or tendon repairs.

Plastic Surgery

Documentation Requirements

Comprehensive documentation of the laceration repair, including techniques used and any grafts or flaps applied.

Common Clinical Scenarios

Reconstructive procedures following traumatic injuries to the thumb.

Billing Considerations

Document cosmetic outcomes and functional assessments post-surgery.

Coding Guidelines

Inclusion Criteria

Use S61.12 When
  • Follow official coding guidelines that specify the need for detailed documentation of the injury's nature, extent, and treatment
  • Include any associated conditions that may affect the coding process
  • Ensure compliance with the ICD
  • CM coding conventions

Exclusion Criteria

Do NOT use S61.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for simple laceration repairs without significant underlying damage.

Documentation Requirements

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

Specialty Considerations

Orthopedic and plastic surgeons should document the extent of the injury and any additional procedures performed.

10120CPT Code

Incision and removal of foreign body

Clinical Scenario

Used when a foreign body is embedded in the laceration and requires surgical removal.

Documentation Requirements

Document the location and type of foreign body, as well as the technique used for removal.

Specialty Considerations

Ensure that the surgical notes detail the procedure and any complications encountered.

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 the differentiation of lacerations with and without foreign bodies. This specificity improves data accuracy and enhances the ability to track injury trends and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including the differentiation of lacerations with and without foreign bodies. This specificity improves data accuracy and enhances the ability to track injury trends and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including the differentiation of lacerations with and without foreign bodies. This specificity improves data accuracy and enhances the ability to track injury trends and treatment 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 importance of documenting the foreign body in a laceration?

Documenting the foreign body is crucial for accurate coding and billing, as it affects the complexity of the injury and the treatment required. It also helps in justifying the medical necessity of the procedures performed.