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ICD-10 Guide
ICD-10 CodesS61.313

S61.313

Billable

Laceration without foreign body of left middle finger with damage to nail

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

Code Description

ICD-10 S61.313 is a billable code used to indicate a diagnosis of laceration without foreign body of left middle finger with damage to nail.

Key Diagnostic Point:

S61.313 describes a laceration of the left middle finger that does not involve a foreign body and includes damage to the nail. This type of injury is common in various settings, including home accidents, workplace injuries, and sports-related incidents. The laceration may vary in depth and severity, potentially affecting not only the skin but also underlying structures such as tendons, nerves, and blood vessels. Damage to the nail can lead to complications such as nail deformity or loss. Proper assessment is crucial to determine the extent of the injury, which may require imaging studies to rule out fractures or tendon injuries. Treatment often involves wound care, possible suturing, and monitoring for signs of infection. In some cases, surgical intervention may be necessary to repair damaged structures or to address complications arising from the injury. Accurate coding is essential for appropriate 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

  • Assessment of injury depth and extent
  • Potential involvement of underlying structures (tendons, nerves)
  • Documentation of nail damage and its implications
  • Differentiation from similar codes for finger injuries

Audit Risk Factors

  • Inadequate documentation of injury specifics
  • Failure to note associated injuries (e.g., fractures, tendon damage)
  • Misclassification of the injury type
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the mechanism of injury, extent of damage, and any surgical interventions performed.

Common Clinical Scenarios

Fractures associated with lacerations, tendon repairs, and nail bed injuries.

Billing Considerations

Ensure clear documentation of any surgical procedures performed, including the type of repair and materials used.

Emergency Medicine

Documentation Requirements

Comprehensive assessment of the injury, including vital signs, pain levels, and initial treatment provided.

Common Clinical Scenarios

Acute lacerations requiring immediate care, assessment for foreign bodies, and potential referrals for surgical intervention.

Billing Considerations

Document the mechanism of injury and any immediate complications observed during the initial evaluation.

Coding Guidelines

Inclusion Criteria

Use S61.313 When
  • According to ICD
  • 10 coding guidelines, S61
  • 313 should be used when the laceration is confirmed to be without foreign body involvement and includes nail damage
  • Coders must ensure that the documentation supports the diagnosis and that all relevant details are captured

Exclusion Criteria

Do NOT use S61.313 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for suturing the laceration on the left middle finger.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons should note any additional procedures performed.

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 lacerations. S61.313 provides detailed information about the injury, which is essential for treatment planning and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including lacerations. S61.313 provides detailed information about the injury, which is essential for treatment planning and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 significance of documenting nail damage in laceration cases?

Documenting nail damage is crucial as it can affect treatment decisions and potential complications. It also impacts the coding accuracy and the reimbursement process.