Surgical Wound ICD-10-CM Codes
Explore the ICD-10-CM codes linked to surgical wounds, essential for precise medical documentation, appropriate billing, and strategic treatment decisions for 2023.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Surgical Wounds?
A surgical wound refers to an incision or cut made into the body by a surgeon during a procedure. Surgical wounds need accurate coding for postoperative care, complications, and billing purposes. The ICD-10-CM provides standardized codes for these surgical-associated conditions.
Commonly Used ICD-10-CM Codes for Surgical Wounds:
T81.30XA - Disruption of wound, unspecified, initial encounter
A generic code used for cases where a surgical wound has come apart, but there's no information on how it occurred.
T81.31XA - Disruption of internal operation (surgical) wound, not elsewhere classified, initial encounter
The wound from an internal surgery has opened up or disrupted, not due to any reasons listed elsewhere.
T81.32XA - Disruption of external operation (surgical) wound, not elsewhere classified, initial encounter
An external surgical wound has come apart, but not for any reasons listed explicitly in other categories.
T81.4XXA - Infection following a procedure, initial encounter
This code indicates a patient has developed an infection due to a surgical procedure.
T81.83XA - Pain during or following a procedure, initial encounter
The patient is experiencing pain either during or after a surgical procedure.
(Note: The term 'initial encounter' typically implies the wound or condition is being treated immediately after the surgery or after discovering the issue, and it may have subsequent codes for follow-ups or complications.)
Which Surgical Wound ICD codes are Billable?
- T81.30XA - Yes
- T81.31XA - Yes
- T81.32XA - Yes
- T81.4XXA - Yes
- T81.83XA - Yes
Clinical Information
- Surgical wounds are intentional incisions made by healthcare providers during procedures.
- They are classified by their cleanliness, depth, and complexity.
- Proper care is crucial to prevent complications such as infections, wound disruptions, or hematomas.
- Signs of complications can include pain beyond expected levels, redness, swelling, pus, or the wound opening up.
- Treatment may involve antibiotics, wound care, or in some cases, further surgical interventions.
Synonyms Include:
- Post-operative wound
- Surgery incision site
- Operative cut
- Surgical site
- Procedure wound
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Commonly asked questions
A Surgical Wound ICD code should be utilized when documenting care related to a patient's surgical incision, especially when addressing complications or specific post-operative care needs.
Treatments include wound care (cleaning and dressing), antibiotics for infections, pain management, or possible corrective surgeries for disruptions.
A diagnosis code for a Surgical Wound signifies issues or care related to an incision made during a surgical procedure, including standard healing or complications that arise.
