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ICD-10 Guide
ICD-10 CodesS61.30

S61.30

Billable

Unspecified open wound of finger with damage to nail

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

Code Description

ICD-10 S61.30 is a billable code used to indicate a diagnosis of unspecified open wound of finger with damage to nail.

Key Diagnostic Point:

An unspecified open wound of the finger with damage to the nail refers to a traumatic injury that results in a break in the skin of the finger, accompanied by injury to the nail. This type of injury can occur due to various mechanisms, including lacerations, punctures, or avulsions. The open wound may expose underlying structures, including tendons, nerves, and bone, which can complicate the injury. The damage to the nail can range from minor abrasions to complete loss of the nail plate. Clinical evaluation is essential to assess the extent of the injury, including any associated fractures or tendon injuries. Treatment may involve wound cleaning, suturing, and possibly surgical intervention if deeper structures are involved. Proper documentation is crucial to capture the specifics of the injury, including the mechanism of injury, the extent of the wound, and any associated complications. This code is often used in emergency settings, outpatient clinics, and surgical contexts, highlighting the need for thorough clinical assessment and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to document associated injuries (e.g., fractures, tendon damage)
  • Use of unspecified codes when more specific codes are available
  • Inconsistent coding across different encounters for the same injury

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with finger lacerations from accidents, sports injuries, or workplace incidents.

Billing Considerations

Ensure that all associated injuries are documented to avoid undercoding or overcoding.

Orthopedic Surgery

Documentation Requirements

Comprehensive documentation of surgical interventions, including any repairs to tendons or fractures.

Common Clinical Scenarios

Surgical repair of complex finger injuries involving tendons and bones.

Billing Considerations

Accurate coding of any surgical procedures performed in conjunction with the wound care.

Coding Guidelines

Inclusion Criteria

Use S61.30 When
  • According to ICD
  • 10 guidelines, this code should be used when the specific nature of the open wound is not documented
  • Coders should ensure that the documentation supports the use of this unspecified code and consider more specific codes if available

Exclusion Criteria

Do NOT use S61.30 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 the open wound on the finger.

Documentation Requirements

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

Specialty Considerations

Ensure that the procedure aligns with the diagnosis for accurate billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding, but the use of unspecified codes like S61.30 can lead to increased scrutiny during audits. Coders must ensure that documentation supports the use of this code to avoid potential denials.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding, but the use of unspecified codes like S61.30 can lead to increased scrutiny during audits. Coders must ensure that documentation supports the use of this code to avoid potential denials.

Reimbursement & Billing Impact

reimbursement and to avoid audits.

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 should I document to support the use of S61.30?

Document the mechanism of injury, the extent of the wound, any associated injuries, and the treatment provided. This will help justify the use of the unspecified code.