Version 2024

2024 ICD-10-CM Diagnosis Code S31.609A

Unspecified open wound of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, initial encounter

ICD-10-CM Code:: S31.609A
ICD-10 Code for:: Unsp opn wnd abd wall, unsp quadrant w penet perit cav, init
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Code Edits
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals
  (S30-S39)
  - Open wound of abdomen, lower back, pelvis and external genitals
    (S31)

S31.609A is a billable diagnosis code used to specify a medical diagnosis of unspecified open wound of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

S31.609A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like unspecified open wound of abdominal wall unspecified quadrant with penetration into peritoneal cavity. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Unspecified diagnosis codes like S31.609A 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.

Approximate Synonyms

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

Bile duct injury with open wound into cavity
Bladder and urethra injury with open wound into cavity
Capsular tear of spleen
Capsular tear without major disruption of parenchyma of spleen AND with open wound in abdominal cavity
Complete disruption of kidney parenchyma with open wound into cavity
Contusion of liver
Crushing injury of abdomen
Fallopian tube injury with open wound into cavity
Gunshot wound of abdomen region
Hematoma and contusion of liver
Hematoma AND contusion of liver with open wound into abdominal cavity
Hematoma of kidney
Hematoma of kidney
Hematoma of kidney without rupture of capsule AND with open wound into abdominal cavity
Hematoma of spleen with open wound into abdominal cavity
Hemorrhage of kidney
Hemorrhage of kidney
Injury of adrenal gland
Injury of adrenal gland with open wound into abdominal cavity
Injury of ascending colon
Injury of ascending right colon with open wound into abdominal cavity
Injury of bile duct
Injury of bladder and urethra
Injury of colon with open wound into abdominal cavity
Injury of colon with open wound into abdominal cavity
Injury of colon with open wound into abdominal cavity
Injury of colon with open wound into abdominal cavity
Injury of colon with open wound into abdominal cavity
Injury of descending colon
Injury of descending left colon with open wound into abdominal cavity
Injury of duodenum with open wound into abdominal cavity
Injury of gallbladder with open wound into abdominal cavity
Injury of gastrointestinal tract with open wound into abdominal cavity
Injury of head of pancreas with open wound into abdominal cavity
Injury of intestine with open wound into abdominal cavity
Injury of kidney with open wound into abdominal cavity
Injury of kidney with open wound into abdominal cavity
Injury of kidney with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of liver with open wound into abdominal cavity
Injury of multiple intra-abdominal organs with open wound into abdominal cavity
Injury of multiple intra-abdominal organs with open wound into abdominal cavity
Injury of multiple intra-abdominal organs with open wound into abdominal cavity
Injury of multiple intra-abdominal organs with open wound into abdominal cavity
Injury of multiple intra-abdominal organs with open wound into abdominal cavity
Injury of multiple pelvic organs
Injury of multiple pelvic organs with open wound into cavity
Injury of multiple sites of colon and/or rectum with open wound into abdominal cavity
Injury of multiple sites of pancreas with open wound into abdominal cavity
Injury of ovary with open wound into abdominal cavity
Injury of prostate
Injury of prostate with open wound into abdominal cavity
Injury of seminal vesicle
Injury of seminal vesicle with open wound into abdominal cavity
Injury of sigmoid colon
Injury of sigmoid colon with open wound into abdominal cavity
Injury of small intestine with open wound into abdominal cavity
Injury of small intestine with open wound into abdominal cavity
Injury of spermatic cord
Injury of spleen with open wound into abdominal cavity
Injury of spleen with open wound into abdominal cavity
Injury of spleen with open wound into abdominal cavity
Injury of spleen with open wound into abdominal cavity
Injury of stomach with open wound into abdominal cavity
Injury of transverse colon
Injury of transverse colon with open wound into abdominal cavity
Injury of ureter with open wound into abdominal cavity
Injury of uterus with open wound into abdominal cavity
Injury of vas deferens
Injury of vas deferens with open wound into abdominal cavity
Internal injury of abdominal organs with open wound into cavity
Kidney hematoma without rupture of capsule, with open wound into cavity
Laceration extending into parenchyma of spleen with open wound into abdominal cavity
Laceration of kidney
Laceration of kidney with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of liver with open wound into abdominal cavity
Laceration of parenchyma of spleen
Laceration of spleen
Laceration of spleen
Liver hematoma
Liver moderate laceration with open wound into cavity
Major laceration of liver with open wound into abdominal cavity
Massive parenchymal disruption of spleen with open wound into abdominal cavity
Minor laceration of liver with open wound into abdominal cavity
Moderate laceration of liver with open wound into abdominal cavity
Multiple injuries of digestive system
Multiple injuries of digestive system
Multiple injuries of digestive system
Multiple injuries of intestine
Multiple injuries of intestine
Multiple injuries of pelvis
Multiple injuries to colon or rectum with open wound into cavity
Multiple open fractures of pelvis with disruption of pelvic circle
Open injury of bladder
Open injury of kidney
Open injury of kidney
Open injury of kidney
Open injury of kidney
Open injury of kidney
Open injury of kidney
Open injury of kidney grade I
Open injury of kidney grade II
Open injury of kidney grade III
Open injury of kidney grade IV
Open injury of kidney grade V
Open injury of spleen
Open injury of spleen
Open injury of spleen
Open injury of uterus
Pancreas body injury with open wound into cavity
Pelvic organ injury with open wound into abdominal cavity
Pelvic organ injury with open wound into abdominal cavity
Pelvic organ injury with open wound into abdominal cavity
Pelvic organ injury with open wound into abdominal cavity
Pelvic organ injury with open wound into abdominal cavity
Pelvic organ injury with open wound into abdominal cavity
Penetrating wound of abdomen
Peritoneum injury with open wound into cavity
Retroperitoneal hematoma
Retroperitoneal hematoma
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Retroperitoneum injury with open wound into cavity
Severe crushing injury of abdominal organs
Severe crushing injury of abdominal organs with open wound into cavity
Spleen injury with hematoma without rupture of capsule, with open wound into cavity
Splenic hematoma
Splenic hematoma
Splenic hemorrhage
Splenic hemorrhage
Stellate laceration of liver with open wound into abdominal cavity
Traumatic hematuria
Traumatic hematuria
Traumatic hemorrhage of liver
Traumatic injury of body of pancreas
Traumatic injury of head of pancreas

Clinical Classification

Clinical Category is Open wounds of trunk, initial encounter
CCSR Category Code: INJ013
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

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

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

Unspecified codes - Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

S31.609A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
393	OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC	06	1.6196
394	OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC	06	0.9369
395	OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC	06	0.6475

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert S31.609A to ICD-9-CM

ICD-9-CM Code: 868.13 - Peritoneum injury-open
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

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 (broken bones)
Sprains and strains

[Learn More in MedlinePlus]

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

S31 Open wound of abdomen, lower back, pelvis and external genitals.
S31.0 Open wound of lower back and pelvis.
S31.00 Unspecified open wound of lower back and pelvis.
S31.000 Unspecified open wound of lower back and pelvis without penetration into retroperitoneum.
S31.000A Unspecified open wound of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.000D Unspecified open wound of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.
S31.000S Unspecified open wound of lower back and pelvis without penetration into retroperitoneum, sequela.
S31.001 Unspecified open wound of lower back and pelvis with penetration into retroperitoneum.
S31.001A Unspecified open wound of lower back and pelvis with penetration into retroperitoneum, initial encounter.
S31.001D Unspecified open wound of lower back and pelvis with penetration into retroperitoneum, subsequent encounter.
S31.001S Unspecified open wound of lower back and pelvis with penetration into retroperitoneum, sequela.
S31.01 Laceration without foreign body of lower back and pelvis.
S31.010 Laceration without foreign body of lower back and pelvis without penetration into retroperitoneum.
S31.010A Laceration without foreign body of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.010D Laceration without foreign body of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.
S31.010S Laceration without foreign body of lower back and pelvis without penetration into retroperitoneum, sequela.
S31.011 Laceration without foreign body of lower back and pelvis with penetration into retroperitoneum.
S31.011A Laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter.
S31.011D Laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, subsequent encounter.
S31.011S Laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, sequela.
S31.02 Laceration with foreign body of lower back and pelvis.
S31.020 Laceration with foreign body of lower back and pelvis without penetration into retroperitoneum.
S31.020A Laceration with foreign body of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.020D Laceration with foreign body of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.
S31.020S Laceration with foreign body of lower back and pelvis without penetration into retroperitoneum, sequela.
S31.021 Laceration with foreign body of lower back and pelvis with penetration into retroperitoneum.
S31.021A Laceration with foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter.
S31.021D Laceration with foreign body of lower back and pelvis with penetration into retroperitoneum, subsequent encounter.
S31.021S Laceration with foreign body of lower back and pelvis with penetration into retroperitoneum, sequela.
S31.03 Puncture wound without foreign body of lower back and pelvis.
S31.030 Puncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum.
S31.030A Puncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.030D Puncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.
S31.030S Puncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum, sequela.
S31.031 Puncture wound without foreign body of lower back and pelvis with penetration into retroperitoneum.
S31.031A Puncture wound without foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter.
S31.031D Puncture wound without foreign body of lower back and pelvis with penetration into retroperitoneum, subsequent encounter.
S31.031S Puncture wound without foreign body of lower back and pelvis with penetration into retroperitoneum, sequela.
S31.04 Puncture wound with foreign body of lower back and pelvis.
S31.040 Puncture wound with foreign body of lower back and pelvis without penetration into retroperitoneum.
S31.040A Puncture wound with foreign body of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.040D Puncture wound with foreign body of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.
S31.040S Puncture wound with foreign body of lower back and pelvis without penetration into retroperitoneum, sequela.
S31.041 Puncture wound with foreign body of lower back and pelvis with penetration into retroperitoneum.
S31.041A Puncture wound with foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter.
S31.041D Puncture wound with foreign body of lower back and pelvis with penetration into retroperitoneum, subsequent encounter.
S31.041S Puncture wound with foreign body of lower back and pelvis with penetration into retroperitoneum, sequela.
S31.05 Open bite of lower back and pelvis.
S31.050 Open bite of lower back and pelvis without penetration into retroperitoneum.
S31.050A Open bite of lower back and pelvis without penetration into retroperitoneum, initial encounter.
S31.050D Open bite of lower back and pelvis without penetration into retroperitoneum, subsequent encounter.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.