2027 ICD-10-CM Diagnosis Code S91.242DPuncture wound with foreign body of left great toe with damage to nail, subsequent encounter
S91.242D is a billable ICD-10-CM diagnosis code for puncture wound with foreign body of left great toe with damage to nail, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds to limbs, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S91.242D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the ankle and foot (S90-S99).
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Open wound of ankle, foot and toes (S91). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to S91.242D: its own notes plus those printed at S91, block S90-S99, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- any associated wound infection
Notes
General instructions on how these codes are used.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category S91
- Ainitial encounter
- Dsubsequent encounter this code
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S91.242D, its category, or a range that includes it.
Excludes2 2
These codes carry an Excludes2 note naming S91.242D: its condition is not part of those codes, and both may be reported when the patient has both.
Code Also 3
These codes say S91.242D may also be needed to fully describe the condition. The note gives no sequencing direction.
- S94 Injury of nerves at ankle and foot levelany associated open wound (S91.-) names S91.-, which includes this code
- S95 Injury of blood vessels at ankle and foot levelany associated open wound (S91.-) names S91.-, which includes this code
- S96 Injury of muscle and tendon at ankle and foot levelany associated open wound (S91.-) names S91.-, which includes this code
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Foreign Bodies
If you've ever gotten a splinter or had sand in your eye, you've had experience with a foreign body. A foreign body is something that is stuck inside you but isn't supposed to be there. You may inhale or swallow a foreign body, or you may get one from an injury to almost any part of your body.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S91.242D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S91.242DOverview
Is S91.242D a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report puncture wound with foreign body of left great toe with damage to nail, subsequent encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character D in S91.242D mean?
The final character D marks a subsequent encounter: use it for routine care while the puncture wound with foreign body of left great toe with damage to nail is healing, after active treatment has ended.
What MS-DRG does S91.242D group to?
When puncture wound with foreign body of left great toe with damage to nail, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 950, 949, with relative weights from 0.7661 to 1.1231 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S91.242D exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for puncture wound with foreign body of left great toe with damage to nail, subsequent encounter on inpatient claims. The code appears in the Injuries to the ankle and foot (S90-S99) range of the CMS exempt list.
Can S91.242D be reported with S92?
Not as a rule. The Excludes1 note at S91, which applies to S91.242D, lists "open fracture of ankle, foot and toes (S92.-with 7th character B)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
