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ICD-10 Guide
ICD-10 CodesS61.259

S61.259

Billable

Open bite of unspecified finger without damage to nail

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

Code Description

ICD-10 S61.259 is a billable code used to indicate a diagnosis of open bite of unspecified finger without damage to nail.

Key Diagnostic Point:

An open bite of the finger is a type of injury characterized by a break in the skin and underlying tissues, typically resulting from a puncture or laceration caused by a bite from an animal or human. This specific code, S61.259, refers to an open bite injury on an unspecified finger that does not involve damage to the nail. Such injuries can lead to significant complications, including infection, tendon injuries, and nerve damage, depending on the depth and location of the bite. The clinical presentation may include pain, swelling, and bleeding at the site of the injury. Proper assessment is crucial to determine the extent of the damage, which may require imaging studies to rule out fractures or tendon injuries. Treatment often involves wound care, possible surgical intervention to repair damaged structures, and prophylactic antibiotics to prevent infection. Accurate coding is essential for appropriate reimbursement and to reflect the complexity of care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of injury specifics
  • Potential for associated injuries (tendons, nerves)
  • Need for precise anatomical localization
  • Differentiation from similar codes (e.g., closed bites)

Audit Risk Factors

  • Inadequate documentation of the injury mechanism
  • Failure to note associated injuries
  • Misclassification of the type of bite
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Detailed account of the injury mechanism, assessment of the wound, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with animal bites, human bites, or accidental bites during sports or activities.

Billing Considerations

Consideration of rabies prophylaxis and tetanus status, as well as the need for imaging to assess for fractures.

Orthopedic Surgery

Documentation Requirements

Comprehensive evaluation of potential tendon and nerve injuries, imaging results, and surgical notes if applicable.

Common Clinical Scenarios

Surgical repair of tendon injuries or reconstruction following severe bite injuries.

Billing Considerations

Documentation must reflect the complexity of surgical procedures and any complications that arise.

Coding Guidelines

Inclusion Criteria

Use S61.259 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury type, location, and any associated complications

Exclusion Criteria

Do NOT use S61.259 When
  • Exclude codes for injuries that involve nail damage or other specific conditions

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for suturing an open bite wound on the finger.

Documentation Requirements

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

Specialty Considerations

Emergency medicine providers should ensure they document the mechanism of injury and any 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 bites, which enhances the ability to track and analyze injury patterns and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which enhances the ability to track and analyze injury patterns and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which enhances the ability to track and analyze injury patterns 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 difference between an open bite and a closed bite?

An open bite involves a break in the skin and exposure of underlying tissues, while a closed bite does not break the skin and may involve bruising or swelling without an open wound.