ICD-10 Code S21.009S

Unspecified open wound of unspecified breast, sequela

Version 2020 Billable Code POA Exempt

Valid for Submission

S21.009S is a billable code used to specify a medical diagnosis of unspecified open wound of unspecified breast, sequela. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10 code S21.009S might also be used to specify conditions or terms like glass in breast, glass in chest, glass in trunk, metal foreign body in breast, metal foreign body in chest, metal foreign body in trunk, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:S21.009S
Short Description:Unspecified open wound of unspecified breast, sequela
Long Description:Unspecified open wound of unspecified breast, sequela

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Glass in breast
  • Glass in chest
  • Glass in trunk
  • Metal foreign body in breast
  • Metal foreign body in chest
  • Metal foreign body in trunk
  • Open wound of breast
  • Open wound of breast with complication
  • Open wound of breast without complication

Diagnostic Related Groups

The ICD-10 code S21.009S is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 604 - TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC
  • 605 - TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC

Present on Admission (POA)

S21.009S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert S21.009S to ICD-9

  • 906.0 - Lt eff opn wnd head/trnk (Approximate Flag)

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Injuries to the thorax (S20-S29)
      • Open wound of thorax (S21)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Breast Diseases

Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common breast changes are

  • Fibrocystic breast changes - lumpiness, thickening and swelling, often just before a woman's period
  • Cysts - fluid-filled lumps
  • Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
  • Intraductal papillomas - growths similar to warts near the nipple
  • Blocked milk ducts
  • Milk production when a woman is not breastfeeding

NIH: National Cancer Institute


[Learn More]

Wounds and Injuries

An injury is damage to your body. It is a general term that refers to harm caused by accidents, falls, hits, weapons, and more. In the U.S., millions of people injure themselves every year. These injuries range from minor to life-threatening. Injuries can happen at work or play, indoors or outdoors, driving a car, or walking across the street.

Wounds are injuries that break the skin or other body tissues. They include cuts, scrapes, scratches, and punctured skin. They often happen because of an accident, but surgery, sutures, and stitches also cause wounds. Minor wounds usually aren't serious, but it is important to clean them. Serious and infected wounds may require first aid followed by a visit to your doctor. You should also seek attention if the wound is deep, you cannot close it yourself, you cannot stop the bleeding or get the dirt out, or it does not heal.

Other common types of injuries include

  • Animal bites
  • Bruises
  • Burns
  • Dislocations
  • Electrical injuries
  • Fractures
  • Sprains and strains

[Learn More]