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ICD-10 Guide
ICD-10 CodesS61.352

S61.352

Billable

Open bite of right middle finger with damage to nail

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

Code Description

ICD-10 S61.352 is a billable code used to indicate a diagnosis of open bite of right middle finger with damage to nail.

Key Diagnostic Point:

An open bite of the right middle finger with damage to the nail typically occurs due to a traumatic injury where the skin is punctured or torn, exposing underlying tissues. This injury can result from various incidents, including animal bites, human bites, or sharp object injuries. The open bite can lead to significant complications, including infection, damage to the nail matrix, and potential involvement of underlying structures such as tendons and nerves. Clinically, patients may present with pain, swelling, and bleeding at the site of injury, along with visible damage to the nail. Treatment often involves cleaning the wound, possible suturing, and monitoring for signs of infection. In severe cases, surgical intervention may be necessary to repair damaged tendons or nerves. Accurate coding is essential for proper treatment documentation and reimbursement, as it reflects the complexity of the injury and the care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Involvement of multiple anatomical structures (skin, nail, underlying tissues)
  • Potential for associated complications (infection, tendon damage)
  • Variability in treatment approaches (conservative vs. surgical)
  • Need for precise documentation of injury mechanism and extent

Audit Risk Factors

  • Inadequate documentation of injury mechanism
  • Failure to note associated complications (e.g., tendon or nerve damage)
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation for treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the extent of injury, surgical findings, and post-operative care.

Common Clinical Scenarios

Fractures or tendon injuries following an open bite, requiring surgical intervention.

Billing Considerations

Ensure clear documentation of any repairs made to tendons or nerves during surgery.

Emergency Medicine

Documentation Requirements

Thorough assessment of the wound, including size, depth, and any signs of infection.

Common Clinical Scenarios

Initial evaluation and treatment of open bites, including wound care and potential referrals.

Billing Considerations

Document the mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S61.352 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate coding based on the specific injury type and location
  • Include any relevant details about associated injuries or complications

Exclusion Criteria

Do NOT use S61.352 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds

Clinical Scenario

Used for initial treatment of the open bite injury.

Documentation Requirements

Document the size and depth of the wound, along with any suturing performed.

Specialty Considerations

Orthopedic surgeons may need to document additional findings related to tendon or nerve involvement.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of injuries, improving the accuracy of patient records and reimbursement processes. S61.352 captures the complexity of open bite injuries more effectively than previous coding systems.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of injuries, improving the accuracy of patient records and reimbursement processes. S61.352 captures the complexity of open bite injuries more effectively than previous coding systems.

Reimbursement & Billing Impact

reimbursement processes. S61.352 captures the complexity of open bite injuries more effectively than previous coding systems.

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 coding S61.352 accurately?

Accurate coding of S61.352 is crucial for proper reimbursement and reflects the complexity of the injury, ensuring that healthcare providers are compensated for the level of care provided.