Is S31.601D a billable ICD-10-CM code?

Yes. S31.601D is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S31.601D sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).

What cannot be coded together with S31.601D?

S31.601D carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S31.601D (S31) and apply to it just the same.

S31.601D

S31.601D — Unspecified open wound of abdominal wall, left upper quadrant with penetration into peritoneal cavity, subsequent encounter

Billable / specific codeICD-10-CMPOA exemptleft

S31.601D is a billable, specific ICD-10-CM code for unspecified open wound of abdominal wall, left upper quadrant with penetration into peritoneal cavity, subsequent encounter. It is valid for submission on a claim.

7th character "D" — subsequent encounter

The appropriate 7th character is to be added to each code from category S31

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S31.601D

These are not written on S31.601D, but they bind it: a note on a category applies to every code beneath it. Billing S31.601D with anything listed here is a denial.

Written on S31 — Open wound of abdomen, lower back, pelvis and external genitals

traumatic amputation of part of abdomen, lower back and pelvis (S38.2-, S38.3)

Excludes2 inherited from the categories above S31.601D

Also inherited, and the opposite of Excludes1: these conditions are not part of S31.601D, but a patient can have both, so you may code both.

Written on S31 — Open wound of abdomen, lower back, pelvis and external genitals

open wound of hip (S71.00-S71.02)
open fracture of pelvis (S32.1--S32.9 with 7th character B)

Risk adjustment

S31.601D does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

S31.601D is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
A56421Billing and Coding: CT of the Abdomen and Pelvis

Code history

S31.601D has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S31.601. If S31.601D is not quite right, the correct code is usually one of these.

Questions about S31.601D

Is S31.601D a billable ICD-10-CM code?: Yes. S31.601D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S31.601D sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).
What cannot be coded together with S31.601D?: S31.601D carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S31.601D (S31) and apply to it just the same.