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ICD-10 Guide
ICD-10 CodesS61.3

S61.3

Billable

Open wound of other finger with damage to nail

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

Code Description

ICD-10 S61.3 is a billable code used to indicate a diagnosis of open wound of other finger with damage to nail.

Key Diagnostic Point:

An open wound of the finger with damage to the nail can occur due to various traumatic incidents such as cuts, lacerations, or punctures. This type of injury often results from accidents involving sharp objects, falls, or crush injuries. Clinically, the open wound may present with bleeding, pain, and swelling, and the damage to the nail can range from minor abrasions to complete avulsion. The severity of the injury can lead to complications such as infection, nail deformity, or even permanent nail loss. Treatment typically involves cleaning the wound, possible suturing, and managing any associated injuries such as fractures or tendon damage. In cases where the nail matrix is affected, surgical intervention may be necessary to repair the nail bed or matrix to ensure proper nail regrowth. Accurate coding is essential for appropriate treatment reimbursement and tracking of injury patterns in hand trauma.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury severity and associated complications
  • Need for detailed documentation of the wound's characteristics
  • Potential for co-existing injuries (e.g., fractures, tendon injuries)
  • Variations in treatment approaches based on specialty

Audit Risk Factors

  • Inadequate documentation of the injury's specifics
  • Failure to document associated injuries
  • Misclassification of the wound type (open vs. closed)
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the injury, treatment provided, and any surgical interventions performed.

Common Clinical Scenarios

Fractures associated with open wounds, tendon repairs, and nail bed surgeries.

Billing Considerations

Ensure that all associated injuries are documented to support the complexity of the case.

Plastic Surgery

Documentation Requirements

Comprehensive notes on wound care, reconstructive procedures, and aesthetic considerations.

Common Clinical Scenarios

Reconstruction of nail beds, management of complex lacerations, and cosmetic repairs.

Billing Considerations

Document the rationale for surgical interventions and any aesthetic outcomes.

Coding Guidelines

Inclusion Criteria

Use S61.3 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the injury's specifics, including the location, type of wound, and any associated injuries

Exclusion Criteria

Do NOT use S61.3 When
  • Exclude codes for closed wounds or injuries not involving the nail

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for minor open wounds of the finger requiring suturing.

Documentation Requirements

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

Specialty Considerations

Orthopedic and plastic surgeons may use this code for repair.

26300CPT Code

Nail bed repair

Clinical Scenario

Indicated 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

Plastic surgeons often perform this procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, improving the accuracy of data collection and reimbursement processes. S61.3 provides a clear distinction for open wounds with nail damage, which was less specific in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, improving the accuracy of data collection and reimbursement processes. S61.3 provides a clear distinction for open wounds with nail damage, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. S61.3 provides a clear distinction for open wounds with nail damage, which was less specific in ICD-9.

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 S61.3 and S61.4?

S61.3 refers specifically to open wounds of the finger with damage to the nail, while S61.4 is for open wounds without nail damage. Accurate coding depends on the specifics of the injury.