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ICD-10 Guide
ICD-10 CodesS61.353

S61.353

Billable

Open bite of left middle finger with damage to nail

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

Code Description

ICD-10 S61.353 is a billable code used to indicate a diagnosis of open bite of left middle finger with damage to nail.

Key Diagnostic Point:

An open bite of the left middle finger with damage to the nail is a specific type of injury that occurs when a sharp object or another person's teeth penetrate the skin and underlying tissues of the finger, resulting in an open wound. This injury can lead to significant trauma to the nail bed, potentially causing nail loss or deformity. The open bite may also involve damage to the surrounding soft tissues, including tendons, nerves, and blood vessels. In cases where the injury is severe, surgical intervention may be required to repair the damaged structures and restore function. The clinical presentation often includes pain, swelling, and bleeding at the site of injury, along with signs of infection if not properly managed. Accurate coding of this condition is crucial for appropriate treatment planning and reimbursement, as it reflects the complexity of the injury and the potential need for surgical repair or other interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Involvement of multiple anatomical structures (skin, nail, soft tissue)
  • Potential for associated injuries (tendon, nerve, vascular)
  • Variability in treatment approaches (conservative vs. surgical)
  • Need for detailed documentation to support coding

Audit Risk Factors

  • Inadequate documentation of the extent of injury
  • Failure to specify associated injuries (e.g., tendon or nerve damage)
  • Misclassification of the type of bite (open vs. closed)
  • Lack of clarity on treatment provided (conservative vs. surgical)

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging studies, and follow-up assessments are necessary to document the extent of injury and treatment provided.

Common Clinical Scenarios

Fractures associated with open bites, tendon repairs, and nail bed reconstructions.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Thorough documentation of the mechanism of injury, initial assessment findings, and treatment provided in the emergency setting.

Common Clinical Scenarios

Initial evaluation and management of open bites, including wound care and potential referral for surgical intervention.

Billing Considerations

Accurate coding requires clear documentation of the injury type and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S61.353 When
  • According to ICD
  • 10 coding guidelines, S61
  • 353 should be used when there is a documented open bite of the left middle finger with nail damage
  • Coders must ensure that the documentation supports the diagnosis and includes details about the injury's severity and any associated injuries

Exclusion Criteria

Do NOT use S61.353 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, as well as the method of repair.

Specialty Considerations

Orthopedic surgeons may perform more complex repairs if associated injuries are present.

26300CPT Code

Nail bed repair

Clinical Scenario

Used when the nail bed is damaged and requires surgical intervention.

Documentation Requirements

Detailed operative notes describing the repair technique and any complications.

Specialty Considerations

Hand surgeons should document the extent of nail damage and any associated soft tissue injuries.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, such as open bites, which helps in better tracking of injury types and treatment outcomes. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, such as open bites, which helps in better tracking of injury types and treatment outcomes. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

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 penetration of the skin and underlying tissues, while a closed bite does not break the skin. Open bites often require more complex treatment and have a higher risk of infection.