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v1.0.0
ICD-10 Guide
ICD-10 CodesS81.0

S81.0

Billable

Open wound of knee

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/26/2025

Code Description

ICD-10 S81.0 is a billable code used to indicate a diagnosis of open wound of knee.

Key Diagnostic Point:

An open wound of the knee refers to a break in the skin and underlying tissues around the knee joint, which can result from trauma, such as falls, sports injuries, or accidents. This type of injury may involve various structures, including the skin, subcutaneous tissue, muscles, tendons, ligaments, and even bones. Open wounds can be classified into different types, such as lacerations, abrasions, and puncture wounds, each varying in severity and treatment requirements. The presence of an open wound increases the risk of infection, necessitating careful management and potential surgical intervention. In cases where the wound is associated with fractures of the tibia or fibula, or ligament tears, comprehensive orthopedic evaluation and treatment are essential. Surgical procedures may include wound debridement, repair of damaged tissues, or reconstructive surgery to restore knee function. Accurate coding of open wounds is crucial for appropriate treatment planning and reimbursement, as it reflects the complexity and severity of the injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential associated injuries (fractures, ligament tears)
  • Need for detailed documentation of wound characteristics
  • Potential for surgical intervention and reconstruction
  • Variability in treatment protocols based on injury severity

Audit Risk Factors

  • Inadequate documentation of wound characteristics
  • Failure to specify associated injuries (fractures, tears)
  • Incorrect coding of the severity of the wound
  • Lack of clarity on treatment provided

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the wound, associated injuries, and surgical procedures performed.

Common Clinical Scenarios

Open knee wounds with associated tibial or fibular fractures, ligament tears requiring surgical repair.

Billing Considerations

Ensure accurate coding of all associated injuries and procedures to reflect the complexity of treatment.

Emergency Medicine

Documentation Requirements

Thorough documentation of the mechanism of injury, initial assessment, and treatment provided.

Common Clinical Scenarios

Patients presenting with traumatic open knee wounds from accidents or sports injuries.

Billing Considerations

Document the urgency of care and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S81.0 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the wound type, associated injuries, and treatment provided
  • Include details on the mechanism of injury and any surgical procedures performed

Exclusion Criteria

Do NOT use S81.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12031CPT Code

Repair of superficial wound

Clinical Scenario

Used for suturing an open knee wound.

Documentation Requirements

Document the size, depth, and location of the wound.

Specialty Considerations

Orthopedic surgeons may need to provide additional details on associated injuries.

27405CPT Code

Arthroscopy, knee, surgical

Clinical Scenario

Used when performing arthroscopic surgery for ligament repair associated with an open knee wound.

Documentation Requirements

Document indications for surgery and findings during the procedure.

Specialty Considerations

Ensure accurate coding of the procedure in relation to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of open wounds, improving the accuracy of claims and facilitating better patient care through detailed documentation of injuries and treatments.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of open wounds, improving the accuracy of claims and facilitating better patient care through detailed documentation of injuries and treatments.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of open wounds, improving the accuracy of claims and facilitating better patient care through detailed documentation of injuries and treatments.

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 wound and a closed wound?

An open wound involves a break in the skin, exposing underlying tissues, while a closed wound does not break the skin and may involve bruising or internal damage.

When should I use S81.0 instead of other knee injury codes?

Use S81.0 specifically for cases where there is an open wound of the knee, particularly when associated with other injuries or requiring surgical intervention.