2026 ICD-10-CM Diagnosis Code S31.15AD
Open bite of abdominal wall, unspecified flank without penetration into peritoneal cavity, subsequent encounter
- ICD-10-CM Code:
- S31.15AD
- ICD-10 Code for:
- Open bite of abd wall, unsp flank w/o penet perit cav, subs
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
S31.15AD is a billable diagnosis code used to specify a medical diagnosis of open bite of abdominal wall, unspecified flank without penetration into peritoneal cavity, subsequent encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S31.15AD is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like open bite of abdominal wall unspecified flank without penetration into peritoneal cavity. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Unspecified diagnosis codes like S31.15AD are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Coding Guidelines
The appropriate 7th character is to be added to each code from block Open wound of abdomen, lower back, pelvis and external genitals (S31). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
New 2026 ICD-10-CM Code
S31.15AD is new to ICD-10-CM code set for the FY 2026, effective October 1, 2025. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2025. This is a new and revised code for the FY 2026 (October 1, 2025 - September 30, 2026).
Present on Admission (POA)
S31.15AD 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. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator: Y
Reason: Diagnosis was present at time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: N
Reason: Diagnosis was not present at time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: U
Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: W
Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: 1
Reason: Unreported/Not used - Exempt from POA reporting.
CMS Pays CC/MCC DRG? NO
Replacement Code
S3115AD replaces the following previously assigned ICD-10-CM code(s):
- S31.159D - Open bite of abd wall, unsp q w/o penet perit cav, subs
Code History
- FY 2026 - Code Added, effective from 10/1/2025 through 9/30/2026
