S81 — Open wound of knee and lower leg
S81 is a non-billable header ICD-10-CM code for open wound of knee and lower leg. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category S81
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- open wound of ankle and foot (S91.-)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any associated wound infection
Other codes that can never be billed with S81
These codes carry an Excludes1 note pointing at S81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S81 alone.
Risk adjustment
S81 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.
Code to one of these instead S81
2 child codes. Green means billable.
Questions about S81
- Is S81 a billable ICD-10-CM code?
- No. S81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S81 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).
- What cannot be coded together with S81?
- S81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.