Infected wound, ICD code 10. Infected wound of the lower leg: bruise, periostitis, phlegmon, bites and injuries, complications and methods of treatment. S13 Dislocation, sprain and strain of capsular-ligamentous apparatus at neck level

Infected soft tissue cavities are complicated wounds with a violation of the integrity of the skin, the addition of pathogenic microflora. The penetration of microbes provokes the development of suppuration, negative symptoms, and a slowdown in the regeneration process. Allocate classification codes for injuries of the hip, knee, ankle, toes are presented in the block section S81.0; S81.8, for the pathology of an infected foot wound, ICD code 10: S91.

Surface contamination can occur at the time of damage or after some time. According to ICD 10, among the features of the infection are:

• the primary process - the cause of infected wounds lies in the infliction of injury with an initially contaminated object, the ingress of microbes from clothing, the penetration of particles of foreign bodies;
• secondary - layering of secondary infection more than a day after the foot injury, the source is dressing material, airborne infection, contamination of the edge of the area, insufficient surgical treatment during disinfection, non-compliance with doctor's recommendations;
• development of symptoms of inflammation according to the ICD, signs of purulent damage: edema, swelling of the joint, local hyperthermia, high body temperature, general weakness, malaise, tachycardia;
• in case of damage to internal organs with deep wounds (stab, torn, incised defect), sutures are applied.

According to ICD 10, the likelihood of developing infection of the lower extremities, in particular the foot, depends on many factors:

• degree of pollution;
• depth of injury;
• impaired immune defense;
• concomitant diseases that weaken the body;
• improper treatment of a wound on the foot.

International classification

Infected damage to the lower extremities is quite common, the different nature of violations of the integrity of the skin of the foot, the muscle layer, various kinds of fractures create an extensive group of diseases in the field of traumatology and surgery.

Feet

According to the ICD-10 classification, an open wound of the ankle and foot has the code S91.

Foot injuries, even without complications, are a threat, the main load of the body falls on the ankle joint, the soles of the foot. Such injuries require immediate medical intervention, the risk of violations of free movement in the future, the displacement of bone structures, the development of inflammatory reactions.

According to ICD 10, an infected foot wound with suppuration is a reason for immediate surgical intervention.

shins

The pathological process of an infected wound of the lower leg, ICD code 10 has S81.9. Suppuration is the most common type of lesion of the lower extremities, this part is most vulnerable to injuries (stretching, blows, scratches, open fractures, bruises with dissection of the skin and soft tissues).

Clinical symptoms include: redness, swelling, severe pain, local hyperemia, pus.

The purulent process of the lower leg, as well as the foot, can be complicated by the development of serious complications of the infected area:

• necrosis of the skin, muscle layer with deep damage to the lower leg;
• periostitis;
• phlegmon and abscess.

Hips

An infected infected wound in the area of ​​the hip joint and thigh is classified by ICD-10 code S71.0.

The lesion is much less common than on the foot, the musculoskeletal frame is protected from external influences, clothing protection prevents even minor scratches and abrasions.

When an infected wound is formed, there is swelling, pain when moving (especially standing up and sitting down), shooting pains along the nerve endings, and the risk of hematogenous spread increases due to the proximity of the main vessels.

knee joint

The classification number of the disease infected wound of the knee joint ICD code 10 is S81.0. In addition to the symptoms characteristic of damage to the lower leg and foot, the addition of atypical microflora provokes:

• an increase in the size of the joint with stretching of the capsule, pain of a cutting, stabbing nature;
• to the touch the knee is hot, sensitive;
• through open surfaces or purulent fistulas, serous contents of an inflammatory nature, a gray viscous liquid, are separated.

toes

The defeat of the infection of the fingers of the lower extremities according to ICD 10 S91.1 according to the International classification. A more severe course is observed, especially with infection and localization of the wound in the interphalangeal spaces, constant friction of the foot, maceration, lack of personal hygiene only exacerbate the purulent process and contribute to the growth of pathogenic microflora.

Treatment and why it is dangerous to delay it

According to ICD 10, procedures for eliminating infected complications, speedy healing are divided into subgroups:

1. General procedures on the recommendation of a doctor - treat the edge of the wound, clean from granulation tissue, daily dressing of the foot with the application of a fresh sterile bandage, personal hygiene, care for the injury.
2. conservative therapy. According to ICD 10, the method includes exposure to the infected area with local drugs (Vishnevsky ointment, Levomekol, Ichthyol liniment, Chlorhexidine, Hydrogen peroxide, Miramistin, Ethyl alcohol) and systemic therapy (antibacterial drugs, parenteral detoxification solutions, immunocorrective agents, vitamin therapy) to eliminate bacterial component of the infected wound, accelerating the regeneration of the foot.
3. A surgical method that includes surgical intervention in complicated situations (cellulitis, deep suppuration with the formation of pyogenic cavities). The surface is opened, necrotic, purulently affected tissues are excised with a scalpel. According to ICD 10, then they are treated with antibacterial solutions, if necessary, stitches are applied, a sterile bandage over the wound. A scar may remain after the procedure.

The danger in the absence of adequate therapy for the infected area of ​​the foot in the spread of infection according to ICD 10, massive dissemination of microbes into the internal organs with impaired function, with blood poisoning - sepsis, increases the threat to the patient's life with the likelihood of death.

recovery prognosis

With timely treatment, careful diagnosis of an infected foot wound by medical personnel, patient compliance with all recommendations regarding treatment, prevention of recurrence of the disease, the prognosis is favorable. According to ICD 10, complete cure is up to 96-100%.

In complicated purulent processes with the presence of blood poisoning, the risk of serious disorders in the body, with infected damage to internal organs, irreversible pathological changes, the prognosis with a favorable outcome for life is 65–71% according to ICD 10.

Only adequately selected therapy with antibacterial drugs, sanitation of purulent foci can help to completely get rid of infected wounds on the foot.

An infected wound of the lower leg (ICD code - S81) is a traumatic injury caused by a violation of the integrity of the skin with concomitant infection. The International Classification of Diseases identifies different types of wounds that affect the area of ​​the knee joint. Injuries can have various features and manifestations.

Types of wounds

Wounding of the surface of the skin occurs as a result of exposure to various external factors. Wounds can be both superficial and deep, with concomitant damage to blood vessels, ligaments, and nerve endings.

Ragged

Such a wound (S81.0) is characterized by uneven edges, and possible separation of the skin from the injured area. Occurs mainly with mechanical impact (hitting the ankle in a working mechanism), in emergency situations, traffic accidents. A characteristic feature is the scale of the wound lesion, the presence of a moderate gaping.

Such wounds are most prone to infection, the development of complications of a purulent nature. Ragged injuries require prolonged healing, which is fraught with the replacement of normal tissue structures with connective ones.

cut

This ankle wound (S81.0) is caused by sharp objects. A characteristic feature of this type is smooth edges, bleeding due to damage to blood vessels over the entire wound area.

Doctors consider incised wounds to be one of the safest. Timely access to a doctor, connection and suturing of even edges promotes rapid healing, regeneration, and virtually eliminates unpleasant consequences such as scars and scars.

stabbed

Such a wound is multiple in nature (ICD10 code - S81.7): it has a small diameter, but a rather impressive depth penetrating into the tissue cavity. Bleeding is not always observed. Doctors point to high risks of purulent processes due to the narrowness, depth and tortuous direction of the wound opening.

bitten

Code S81.0. From the name it becomes clear that the wound occurs due to the bite of an animal (domestic or wild). It has uneven edges and a fairly large depth. The extent and severity of the bitten injury depends on the size of the animal and the severity of the bite.

Due to the initial contamination with saliva, there is a high probability of suppuration, infection and other adverse effects. Therefore, in such situations, it is required not only to carry out disinfection, but also to vaccinate against rabies and tetanus.

open

Such a wound (S81) is accompanied by a rupture of the skin. It has a high risk of developing a purulent process as a result of the ingress of pathogens through an object that was injured, clothing, etc. With a large depth of the wound opening, concomitant damage to muscle fibers, blood vessels, nerve endings, ankle joint and bone can be observed.

infected

This is a complicated wound (code S81), characterized by the addition of infectious processes. The provoking factor is pathogenic pathogens, bacteria penetrating into the wound opening.

Accompanied by redness and hyperemia of the skin, swelling, pronounced pain syndrome. In advanced and severe clinical cases, there may be a general intoxication of the body with a clinical picture characteristic of this condition.

Causes and symptoms

Among the possible causes of the appearance of wounds of the lower leg, doctors distinguish:

• mechanical damage;
• emergencies, traffic accidents;
• bites;
• impact with a sharp object.

Symptoms of an open wound are specific, visible even to the naked eye. Among the main clinical signs are:

• rupture of the skin;
• hiatus;
• bleeding (can be both strong and insignificant);
• the edges of the skin diverging to the sides, forming a wound surface;
• pain syndrome.

Infection is characterized by symptoms such as reddening of the skin around the affected area, pronounced pain, swelling, increased local body temperature, and possibly purulent discharge. In especially severe cases, intoxication of the body is noted, accompanied by fever, headaches, nausea and vomiting, and general weakness.

Diagnostics

Diagnosing shin wounds is not difficult for doctors. The diagnosis is made on the basis of examination of the patient, based on the clinical picture, the collected anamnesis. For very deep wounds, additional radiography or ultrasound may be required to exclude damage to bone tissue, nerves, tendons, and joints.

First aid

In order to avoid infection and other unpleasant complications when receiving a wound of the knee joint, it is important to provide the victim with competent first aid in a timely manner.

First of all, the injured area is treated with an antiseptic solution, after which a sterile bandage is applied (from the ankle to the thigh).

In case of bleeding, a pressure gauze bandage will be required, which should be firmly pressed with the palm of your hand for several minutes before bandaging. It is desirable to give the injured limb an elevated position by placing a roller or pillow under it.

If the victim complains of severe pain, you can give him a tablet of an analgesic drug.

Of particular danger are large, large-scale wounds. In such cases, it is necessary to ensure the immobilization of the limb (from the ankle to the thigh), using any means at hand, bandages or gauze, and then take the patient to the emergency room as soon as possible.

Treatment

Wound therapy involves sanitation and disinfection. For these purposes, the injured area is regularly treated with iodine or brilliant green. With open wounds, it is recommended to treat the wound site with antiseptic agents 1-2 times a day, and then apply a bandage with wound healing ointments (Levomekol).

If inflammation, an infectious process occurs, it is imperative to consult a doctor who will prescribe competent treatment with the use of antibiotic, painkillers, non-steroidal anti-inflammatory drugs.

Rehabilitation

Recovery after treatment of shin wounds is short. For a month, the patient is advised to refrain from increased physical activity, sports (in order to avoid divergence of the edges of the wound surface). A good effect will give the use of vitamin-mineral complexes, immunomodulators, activating the body's defense mechanisms, regeneration.

Possible Complications

An open wound of the lower leg (in the ICD-10 code S81), in the absence of timely first aid and proper treatment, can provoke undesirable consequences:

• suppuration;
• accession of infectious processes;
• phlegmon;
• intoxication of the body;
• inflammatory processes;
• sepsis, blood poisoning;
• heavy bleeding.

Some of these complications threaten not only the health, but also the life of the victim. However, they can be easily avoided by disinfecting and properly treating the wound on the lower leg in a timely manner.

Prevention

Measures for the prevention of wounds involve, first of all, attentiveness and caution when working with various mechanisms, while traveling and in other extreme situations.

In order to prevent infection and related complications, first aid, disinfection is important, preventing the penetration of dust, dirt, microbes and bacteria into the wound.

Wounds of the lower leg are a common occurrence. Upon receipt of such damage, it is necessary to treat the injured surface with an antibacterial agent in time and then use the treatment methods recommended by the doctor. It is required to immediately seek medical help if there are signs of infection, suppuration.

Wound- trauma to any part of the body (especially caused by physical impact), manifested by a violation of the integrity of the skin and / or mucous membrane.

If the patient has signs of phlegmon, a mandatory procedure is surgical intervention. During the operation, the wound is opened with a special instrument, then the surgeon excises dead tissue.

It is also mandatory to take a wound discharge for the study of microflora, its sensitivity to specific groups of antibiotics.

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Frequency. Dog bites are noted by 12:1,000 of the population. Cat bites - 16:10,000.

Code according to the international classification of diseases ICD-10:

The reasons

Risk factors. Dogs bite more often in the afternoon, especially in warm or hot weather, and do not like scantily clad people. Cats bite more often in the morning. Alcohol Intake: Dogs do not like the smell of alcohol.

Symptoms (signs)

Clinical picture- bite wounds are represented by abrasions, scratches, the edges of the wound are usually torn, crushed.

Diagnostics

Research methods. 75% of bitten wounds are infected - it is possible to inoculate a culture of microorganisms. X-ray examination of the affected area to exclude bone damage and follow-up in dynamics when osteomyelitis is suspected.

Treatment

TREATMENT

Surgery. Primary surgical treatment of the wound with the removal of non-viable tissues. Wound suturing is possible if the bite occurred no more than 12 hours ago, a full-fledged primary surgical treatment has been performed, and also if the surgeon is confident that infection cannot develop in the wound. The imposition of primary - delayed sutures 3-5 days after the bite is optimal for obviously infected wounds and the inability to prevent the development of infection only by primary surgical treatment. In case of fractures of the bones of the hand, a splint is necessary.

Drug therapy

The introduction of anti-rabies serum for the prevention of rabies.

The introduction of tetanus toxoid (immunized patients, if more than 5 years have passed since the last vaccination) - see Tetanus.

Human tetanus immunoglobulin in incomplete primary immunization (see Tetanus).

Prophylactic therapy in the first 12 hours after the bite .. Phenoxymethylpenicillin 500 mg orally 4 r / day (children 50 mg / kg / day orally 2 r / day) for 3 days .. Other drugs - amoxicillin 500 mg orally 3 r / day for adults and 40 mg / kg / day 3 r / day for children, or amoxicillin + clavulanic acid 250-500 mg orally 3 r / day for adults and 20-40 mg / kg / day 3 r / day for children.

When the first signs of infection appear - amoxicillin + clavulanic acid (until the results of bacteriological studies are obtained).

Alternative therapy (prophylactic or empiric) in patients allergic to penicillin. Doxycycline. Contraindicated in children under 8 years of age, pregnant and breastfeeding women. Ceftriaxone or erythromycin. Cephalexin should not be used due to resistance of P. multocida strains. Approximately 10% of patients allergic to penicillin develop cross-allergy to cephalosporins.

Complications. Septic arthritis. Osteomyelitis. Extensive soft tissue damage with scarring and subsequent deformity, sometimes with loss of function. Sepsis. Bleeding. Gas gangrene. Rabies. Tetanus. Cat scratch disease.

Forecast. In the absence of complications, the wounds heal by secondary intention after 7-10 days.

ICD-10 . W54 A bite or blow inflicted by a dog. W55 Bite or strike inflicted by other mammals

Any violation of the integrity of the skin can lead to the development of an infectious process. Pathogenic microbes enter the body through an open wound. In medicine, this phenomenon is called primary infection. Also, the process can begin later - this is a secondary infection, it is characterized by a more severe course.

An infected leg wound, according to the International Classification of Diseases (ICD) in edition 10, has several codes, depending on the cause:

• S80. Superficial. For example, a bruise that is not accompanied by a violation of the integrity of tissues. The infection process does not develop immediately after injury.
• S81. Open wound of the leg. The purulent process begins as a result of the ingress of dirt from clothing, a traumatic object.
• S82. Fracture of the leg.
• S87. Crushing of the leg.
• S88. Traumatic amputation of the leg.
• S89. Other and unspecified injuries.

Each of these conditions has a different clinical picture, treatment regimen.

general description

Special plaster for open wounds

Wound infection can occur immediately at the time of injury or after some time. In the latter case, the source is bandages, mucous membranes surrounding the damaged area, and foci of inflammation in the body of the victim.

Important: not all cases of microbial contamination of wounds end in the development of an infectious process.

The likelihood of developing an infection is determined by a whole range of reasons:

• pollution intensity;
• the degree of violation of tissue viability;
• general reactivity of the body (the ability to respond to stimuli from the external environment).

The nature of the microbes that got into the wound manifests itself 6-8 hours after the injury. A favorable environment for their development is non-viable tissues, areas of abundant hemorrhages. That is why it is an open wound that is more often than other injuries accompanied by purulent inflammation.

The development of infection is accompanied by:

• reddening of the edges of the wound;
• the release of purulent contents (if it is open);
• swelling of the damaged area;
• local temperature increase;
• pain syndrome.

In addition to local symptoms, there is also a general deterioration in the patient's well-being. This is manifested in a change in the leukocyte blood formula (the so-called shift of the formula to the left), a decrease in appetite, and an increase in heart rate.

If the wound was sutured and infection occurred during the operation due to insufficient cleaning of the damaged area, the pain syndrome will be pronounced.

Pathologies of the lower leg, accompanied by a purulent process

An infected wound on the leg can develop as a result of various traumatic injuries. The clinical picture is generally general - redness, swelling, pus. The tactics of treatment is determined by the general condition against which an infectious lesion developed.

Shin bruise

Shin examination

You can get such an injury playing sports, falling or directly in contact with hard objects. Often, a bruised wound of the lower leg is diagnosed after hitting the legs of furniture, corners, jambs. Usually, the injury is not complicated by serious consequences, provided that medical care is provided in a timely manner.

With such damage, the pain syndrome is pronounced, which is localized directly at the site of impact. If the pain shock is extensive, the victim may lose consciousness.

After a while, the following symptoms appear:

• swelling of soft tissues;
• difficulty of movement;
• hematomas;
• increase in pain syndrome.

The exact diagnosis is established by the doctor on the basis of the examination, the results of radiography, ultrasound and MRI.

A purulent process with a bruise can develop in case of untimely seeking medical help. This condition accompanies a number of pathologies:

Necrotic process on the skin

Accompanied by severe injury. A victim diagnosed with tissue death must be hospitalized.

Periostitis

Inflammation of the anterior part of the lower leg due to the proximity of the skin and bone. The clinical picture is a pronounced pain syndrome, fever. Periostitis is treated with medicines exclusively from the group of antibiotics.

Phlegmon

A purulent process that affects the tissues of the ligaments, muscles, joints. If the correct treatment is not started in time, the process can affect the skeleton. The first stage of treatment is surgery. Next, the victim is prescribed physiotherapy and a course of drugs aimed at raising immunity.

Open damage

Phlegmonous-edematous form of damage

Open shin injuries are the result of contact with a blunt object when the force of its impact exceeds the natural ability of tissues to stretch.

lacerated wound of the leg

It is accompanied by a violation of the integral skin, soft tissues. Causes - household injuries, accidents, incidents with the use of knives or firearms, falling from a height, careless handling of tools. Lacerations of the lower leg are often found in children in the summer.

Main symptoms:

• pain syndrome;
• bleeding. Its intensity directly depends on which vessels were damaged.

The depth of an open wound rarely goes beyond the fat layer. However, if the blow fell on the front of the lower leg, it is possible that muscle fibers and torn tendons will be noticeable. Particles of objects with which the limb was in contact at the time of injury can enter the wound.

Individual objects can scalp the skin during impact, resulting in drooping or even torn areas. This increases the risk of bleeding, bruising.

A similar condition is observed with open fractures, as well as amputations of a traumatic type.

The task of the doctor is to clean the wound as much as possible from the remnants of the affected tissues, small particles of the object that caused the injury.

Incised wound of the leg

The result of injury to the leg with a sharp object. The edges are straight and the corners are sharp. At the wound channel, the length prevails over the width. It is possible to get this kind of injury in everyday life, catching on something sharp, during an accident or a criminal attack.

The object that caused the injury is usually not sterile, which increases the risk of an infectious process. The more time has passed from the moment of injury to the provision of first aid, the higher the risk of infection.

Animal bites

A bitten wound of the lower leg, according to the International Classification of Diseases, 10th edition, is encrypted with several codes - W53 - W55.

Fact: There are 12 cases of dog bites per 1000 people. The ratio of cat bites is 16:10,000. Dog attacks are more common in the afternoon.

Regardless of who bitten, the clinical picture is similar. Symptoms of injury - abrasions, scratches, torn edges, crushed tissue.

As practice shows, in 75% of recorded cases of bites of adults and children, cultures of pathogens are sown.

What complications develop during infection

Bandage to protect the wound from infection

Against the background of injury and weakened immunity, an inflammatory process develops. With insufficient treatment of the wound, signs of infection appear. In sepsis, the incubation period lasts from 2 days to 2-4 months.

Sepsis of the lower leg develops in several stages:

1. Spicy. Characterized by an increase in body temperature, fever. The skin becomes earthy. The pulse is palpable very weakly, tachycardia is often noted, signs of anemia are activated, and blood pressure decreases. Some victims are diagnosed with leukocytosis. The surface of the wound is dry, easily damaged and bleeds. When acute sepsis is detected, doctors recommend surgery.
2. Subacute. The general clinical picture is similar to the symptoms of the acute period. But the complete absence of chills or its lower intensity is characteristic; fever instability; enlargement of the spleen.
3. Chronic. At this stage, the infection has spread throughout the body and the treatment of an exclusive infected organ does not give the desired result. The main symptom is a fever of an undulating nature. It is possible that for some time the clinical picture will be completely absent. In some patients, hot flashes, attacks of increased sweating are noted, and the work of internal organs is disrupted. With this form, the treatment will be delayed for a long time.

Important : the severe course of the acute form of sepsis can lead to the death of the deceased 2-14 days after the injury. In the case of a subacute course, death can occur on the 60th day, and chronic - on the fourth month.

Medical tactics

Dressing an open wound

It is possible to avoid the development of an infected leg wound if treatment is started in a timely manner. Suppression of the infectious process accelerates wound healing.

To ensure the outflow of pus that has accumulated deep under the crust, it should be soaked. The best way to do this is to use hydrogen peroxide. Sometimes pus accumulates under the skin flap. In this case, the doctor makes a small hole at the edge of the flap and gently squeezes out the contents.

Daily peroxide treatment is a mandatory procedure for open, lacerated or bitten wounds of the lower leg. After thorough cleaning, a bandage with Levomekol ointment should be applied, so the wound will heal faster.

If the patient has signs of phlegmon, surgical intervention is mandatory.

During the operation, the surgeon opens the wound with a special tool and excised dead tissue.

It is also mandatory to take a discharge for the study of microflora, its sensitivity to specific groups of antibiotics, in order to select the most effective drugs.

ICD 10. CLASS XIX. INJURY, POISONING AND CERTAIN OTHER CONSEQUENCES OF EXTERNAL CAUSES (S00-S99)

Excludes: birth trauma ( P10-P15)
obstetric trauma ( O70-O71)

This class contains the following blocks:
S00-S09 Head injury
S10 -S19 Neck injury
S20-S29 Chest injury
S30-S39 Injuries to the abdomen, lower back, lumbar spine and pelvis
S40-S49 Shoulder girdle and shoulder injuries
S50-S59 Elbow and forearm injuries
S60-S69 Wrist and hand injuries
S70-S79 Hip and hip injuries
S80-S89 Knee and ankle injuries

S90-S99 Ankle and foot injuries

In this class, the S section is used to code for various types of injuries related to a specific area of ​​the body, and the T section is used to code multiple injuries and injuries of certain unspecified parts of the body, as well as poisoning and some other effects of exposure. external reasons.
In cases where the heading indicates the multiple nature of the injury, the union "c" means the simultaneous defeat of both named areas of the body, and the union "and" - both one and both areas. The principle of multiple injury coding should be applied as widely as possible Combined rubrics for multiple injuries are given for use when there is insufficient detail on the nature of each individual injury or in primary statistical developments when
it is more convenient to register a single code; in other cases, each component of the injury should be coded separately. In addition, the rules for coding morbidity and mortality in v2 should be taken into account. Section S blocks, as well as rubrics T00-T14 and T90-T98 include injuries that, at the three-character rubric level, are classified by type as follows:

Superficial injury, including:
abrasion
water bubble (non-thermal)
contusion, including bruising, bruising, and hematoma
injury from a superficial foreign body (splinter) without major
open wound
insect bite (non-poisonous)

Open wound, including:
bitten
cut
torn
chipped:
NOS
with (penetrating) foreign body

Fracture, including:
closed:
comminuted)
depressed)
speaker)
split)
incomplete)
impacted) with or without delayed healing
linear)
marching)
simple )
offset)
epiphysis)
helical
with dislocation
offset

Fracture:
open:
difficult )
infected)
gunshot) with or without delayed healing
with puncture wound)
with foreign body)

Excludes: fracture:
pathological ( M84.4)
with osteoporosis ( M80. -)
stressful ( M84.3)
misaligned ( M84.0)
ununited [false joint] ( M84.1)

Dislocations, sprains and overstrain of the capsular-ligamentous apparatus
joints, including:
separation)
gap)
stretching)
overvoltage)
traumatic: - joint (capsule) ligament
hemarthrosis)
tear)
subluxation)
gap)

Nerve and spinal cord injury, including:
complete or incomplete spinal cord injury
violation of the integrity of the nerves and spinal cord
traumatic(th)(s):
nerve intersection
hematomyelia
paralysis (transient)
paraplegia
quadriplegia

Damage to blood vessels, including:
separation)
dissection)
tear)
traumatic(s): ) blood vessels
aneurysm or fistula (arteriovenous)
arterial hematoma)
gap)

Muscle and tendon injuries, including:
separation)
dissection)
tear) muscles and tendons
traumatic rupture)

Crush [crush]

Traumatic amputation

Trauma to internal organs, including:
from the blast wave)
bruising)
concussion injury)
crush)
dissection)
traumatic(s): internal organs
hematoma)
puncture)
gap)
tear)

Other and unspecified injuries

HEAD INJURIES (S00-S09)

Included: injuries:
ear
eyes
face (any part)
gums
jaws
temporomandibular joint area
oral cavity
sky
periocular area
scalp
language
tooth

Excluded: T20-T32)
effects of foreign bodies in:
ear ( T16)
larynx ( T17.3)
mouth ( T18.0)
nose ( T17.0-T17.1)
throat ( T17.2)
outer parts of the eye T15. -)
frostbite ( T33-T35)
bite and sting of a poisonous insect ( T63.4)

S00 Superficial head injury

Excludes: brain contusion (diffuse) ( S06.2)
focal ( S06.3)
trauma to the eye and orbit S05. -)

S00.0 Superficial injury to the scalp
S00.1 Contusion of the eyelid and periorbital region. Bruise in the eye area
Excludes: contusion of the eyeball and tissues of the orbit ( S05.1)
S00.2 Other superficial injuries of the eyelid and periorbital region
Excludes: superficial injury of conjunctiva and cornea ( S05.0)
S00.3 Superficial trauma to the nose
S00.4 Superficial ear injury
S00.5 Superficial injury of the lip and oral cavity
S00.7 Multiple superficial head injuries
S00.8 Superficial trauma to other parts of the head
S00.9 Superficial head injury, unspecified location

S01 Open wound of head

Excluded: decapitation ( S18)
trauma to the eye and orbit S05. -)
traumatic amputation of a part of the head ( S08. -)

S01.0 Open wound of the scalp
Excluded: scalp avulsion ( S08.0)
S01.1 Open wound of the eyelid and periorbital region
Open wound of the eyelid and periorbital region with or without involvement of the lacrimal ducts
S01.2 Open wound of the nose
S01.3 Open ear wound
S01.4 Open wound of the cheek and temporomandibular region
S01.5 Open wound of the lip and oral cavity
Excludes: tooth dislocation ( S03.2)
tooth fracture ( S02.5)
S01.7 Multiple open head wounds
S01.8 Open wound of other areas of the head
S01.9 Open head wound of unspecified location

S02 Fracture of skull and facial bones

Note In the primary statistical development of fractures of the skull and facial bones, combined with intracranial trauma, one should be guided by the rules and instructions for coding the incidence
and mortality as outlined in ch2. The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture or open wound; if the fracture is not characterized as open or closed, it should be
classify as private:
0 - closed
1 - open

S02.0 Fracture of the cranial vault. Frontal bone. parietal bone
S02.1 Fracture of the base of the skull
Pits:
front
middle
rear
Occipital bone. Upper wall of the eye socket. Sinuses:
ethmoid bone
frontal bone
Sphenoid bone
temporal bone
Excludes: eye sockets NOS ( S02.8)
the bottom of the eye socket ( S02.3)
S02.2 Fracture of the bones of the nose
S02.3 Fracture of the bottom of the orbit
Excludes: eye sockets NOS ( S02.8)
upper wall of the orbit S02.1)
S02.4 Fracture of the zygomatic bone and upper jaw. Upper jaw (bones). zygomatic arch
S02.5 Tooth fracture. broken tooth
S02.6 Fracture of the lower jaw. Mandible (bones)
S02.7 Multiple fractures of the skull and facial bones
S02.8 Fractures of other facial bones and bones of the skull. Alveolar process. Eye sockets NOS. Palatine bone
Excludes: eye sockets:
bottom ( S02.3)
upper wall ( S02.1)
S02.9 Fracture of an unspecified part of the bones of the skull and facial bones

S03 Dislocation, sprain and strain of joints and ligaments of head

S03.0 Dislocation of the jaw. Jaws (cartilage) (meniscus). lower jaw. temporomandibular joint
S03.1 Dislocation of the cartilaginous septum of the nose
S03.2 dislocation of the tooth
S03.3 Dislocation of other and unspecified regions of the head
S03.4 Sprain and strain of the joint (ligaments) of the jaw. Temporomandibular joint (ligaments)
S03.5 Sprain and strain of joints and ligaments of other and unspecified parts of the head

S04 Injury of cranial nerves

S04.0 Injury to the optic nerve and visual pathways
visual intersection. 2nd cranial nerve. visual cortex
S04.1 Trauma of the oculomotor nerve. 3rd cranial nerve
S04.2 Block nerve injury. 4th cranial nerve
S04.3 Trigeminal nerve injury. 5th cranial nerve
S04.4 Abducens nerve injury. 6th cranial nerve
S04.5 Facial nerve injury. 7th cranial nerve
S04.6 Acoustic nerve injury. 8th cranial nerve
S04.7 Accessory nerve injury. 11th cranial nerve
S04.8 Injury to other cranial nerves
Glossopharyngeal nerve
hypoglossal nerve
Olfactory nerve
vagus nerve
S04.9 Cranial nerve injury, unspecified

S05 Injury of eye and orbit

Excludes: injury:
oculomotor nerve ( S04.1)
optic nerve ( S04.0)
open wound of the eyelid and periorbital region ( S01.1)
orbital bone fracture S02.1, S02.3, S02.8)
superficial trauma of the eyelid ( S00.1-S00.2)

S05.0 Conjunctival injury and corneal abrasion without mention of a foreign body
Excludes: foreign body in:
conjunctival sac ( T15.1)
cornea ( T15.0)
S05.1 Contusion of the eyeball and tissues of the orbit. Traumatic hyphema
Excludes: bruising around the eye ( S00.1)
contusion of the eyelid and periocular region ( S00.1)
S05.2 Laceration of the eye with prolapse or loss of intraocular tissue
S05.3 Laceration of the eye without prolapse or loss of intraocular tissue. Eye laceration NOS
S05.4 Penetrating wound of the orbit with or without a foreign body
Excludes: non-removed (long-standing in the orbit) foreign body due to a penetrating injury to the orbit ( H05.5)
S05.5 Penetrating wound of the eyeball with a foreign body
Excludes: non-removed (long-standing in the eyeball) foreign body ( H44.6-H44.7)
S05.6 Penetrating wound of the eyeball without a foreign body. Penetrating wound of eye NOS
S05.7 Avulsion of the eyeball. Traumatic enucleation
S05.8 Other injuries of the eye and orbit. Lacrimal duct injury
S05.9 Trauma to an unspecified part of the eye and orbit. Eye injury NOS

S06 Intracranial injury

Note In the primary statistical development of intracranial injuries associated with fractures, one should
be guided by the rules and instructions for coding morbidity and mortality set out in Part 2.
The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify intracranial injury and open wound:
0 - no open intracranial wound
1 - with an open intracranial wound

S06.0 Brain concussion. Commotio cerebri
S06.1 Traumatic cerebral edema
S06.2 Diffuse brain injury. Brain (contusion NOS, rupture NOS)
Traumatic compression of the brain NOS
S06.3 Focal brain injury
Focal(th)(th):
cerebral
contusion
gap
traumatic intracerebral hemorrhage
S06.4 epidural hemorrhage. Extradural hemorrhage (traumatic)
S06.5 Traumatic subdural hemorrhage
S06.6 Traumatic subarachnoid hemorrhage
S06.7 Intracranial injury with prolonged coma
S06.8 Other intracranial injuries
Traumatic hemorrhage:
cerebellar
intracranial NOS
S06.9 Intracranial injury, unspecified. Brain injury NOS
Excludes: head injury NOS ( S09.9)

S07 Crush head

S07.0 Crush face
S07.1 Skull crush
S07.8 Crushing of other parts of the head
S07.9 Crushing of an unspecified part of the head

S08 Traumatic amputation of part of head

S08.0 Avulsion of the scalp
S08.1 Traumatic ear amputation
S08.8 Traumatic amputation of other parts of the head
S08.9 Traumatic amputation of an unspecified part of the head
Excluded: decapitation ( S18)

S09 Other and unspecified injuries of head

S09.0 Injury to the blood vessels of the head, not elsewhere classified
Excludes: injury:
cerebral blood vessels ( S06. -)
precerebral blood vessels ( S15. -)
S09.1 Head muscle and tendon injury
S09.2 Traumatic rupture of the eardrum
S09.7 Multiple head injuries.
S00-S09.2
S09.8 Other specified head injuries
S09.9 Head injury, unspecified
Injury:
faces NOS
ear NOS
nose NOS

NECK INJURIES (S10-S19)

Included: injuries:
back of the neck
supraclavicular region
throat
T20-T32)
larynx ( T17.3)
esophagus ( T18.1)
throat ( T17.2)
trachea ( T17.4)
vertebral fracture NOS ( T08)
frostbite ( T33-T35)
injury:
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
T63.4)

S10 Superficial injury of neck

S10.0 Throat injury. cervical esophagus. Larynx. Throats. Trachea
S10.1 Other and unspecified superficial injuries of the throat
S10.7 Multiple superficial neck injuries
S10.8 Superficial trauma to other parts of the neck
S10.9 Superficial injury of unspecified part of neck

S11 Open wound of neck

Excluded: decapitation ( S18)

S11.0 Open wound involving the larynx and trachea
Open wound of the trachea:
NOS
cervical
Excludes: thoracic trachea ( S27.5)
S11.1 Open wound affecting the thyroid gland
S11.2 Open wound involving the pharynx and cervical esophagus
Excludes: esophagus NOS ( S27.8)
S11.7 Multiple open wounds of the neck
S11.8 Open wound of other parts of the neck
S11.9 Open wound of unspecified part of neck

S12 Fracture of cervical spine

Included: cervical region:
vertebral arches
spine
spinous process
transverse process
vertebra
0 - closed
1 - open

S12.0 Fracture of the first cervical vertebra. Atlas
S12.1 Fracture of the second cervical vertebra. Axis
S12.2 Fracture of other specified cervical vertebrae
Excludes: multiple fractures of cervical vertebrae ( S12.7)
S12.7 Multiple fractures of the cervical vertebrae
S12.8 Fracture of other parts of the neck. Hyoid bone. Larynx. thyroid cartilage. Trachea
S12.9 Fracture of the neck, unspecified location
Fracture of the cervical (section):
vertebra NOS
spine NOS

S13 Dislocation, sprain and strain of capsular-ligamentous apparatus at neck level

Excludes: rupture or displacement (non-traumatic) of intervertebral disc in cervical region ( M50. -)

S13.0 Traumatic rupture of the intervertebral disc at the level of the neck
S13.1 Dislocation of the cervical vertebra. Cervical spine NOS
S13.2 Dislocation of other and unspecified part of neck
S13.3 Multiple dislocations at neck level
S13.4 Stretching and straining of the ligamentous apparatus of the cervical spine
Anterior longitudinal ligament of the cervical region. Atlantoaxial joint. Atlanto-occipital joint
Whiplash injury
S13.5 Stretching and overstrain of the ligamentous apparatus in the thyroid gland
Cricoarytenoid (th) (joint) (ligament). Cricothyroid (th) (joint) (ligament). thyroid cartilage
S13.6 Sprain and strain of joints and ligaments of other and unspecified parts of the neck

S14 Injury of nerves and spinal cord at neck level

S14.0 Contusion and edema of the cervical spinal cord
S14.1 Other and unspecified injuries of the cervical spinal cord. Cervical spinal cord injury NOS
S14.2 Nerve root injury of the cervical spine
S14.3 Brachial plexus injury

S14.4 Injury to the peripheral nerves of the neck
S14.5 Injury of the sympathetic nerves of the cervical spine
S14.6 Injury to other and unspecified nerves of the neck

S15 Injury of blood vessels at neck level

S15.0 Carotid injury. Carotid artery (common) (external) (internal)
S15.1 Vertebral artery injury
S15.2 External jugular vein injury
S15.3 Injury to the internal jugular vein
S15.7 Injury to multiple blood vessels at neck level
S15.8 Injury to other blood vessels at neck level
S15.9 Injury to unspecified blood vessel at neck level

S16 Injury of muscles and tendons at neck level

S17 Crush neck

S17.0 Crushing of the larynx and trachea
S17.8 Crushing of other parts of the neck
S17.9 Crushing of an unspecified part of the neck

S18 Traumatic amputation at neck level. Decapitation

S19 Other and unspecified neck injuries
S19.7 Multiple neck injuries. Injuries classified by more than one of the rubrics S10-S18
S19.8 Other specified neck injuries
S19.9 Neck injury, unspecified

CHEST INJURIES (S20-S29)

Included: injuries:
mammary gland
chest (walls)
interscapular region
Excludes: thermal and chemical burns ( T20-T32)
consequences of penetration of foreign bodies into:
bronchi ( T17.5)
lungs ( T17.8)
esophagus ( T18.1)
trachea ( T17.4)
vertebral fracture NOS ( T08)
frostbite ( T33-T35)
injuries:
armpit)
clavicle)
scapular region) ( S40-S49)
shoulder joint)
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
bite or sting of a poisonous insect ( T63.4)

S20 Superficial injury of chest

S20.0 Breast contusion
S20.1 Other and unspecified superficial injuries of the breast
S20.2 Chest injury
S20.3 Other superficial injuries of the anterior chest wall
S20.4 Other superficial injuries of the posterior chest wall
S20.7 Multiple superficial chest injuries
S20.8 Superficial injury to another and unspecified part of the chest. Chest wall NOS

S21 Open wound of chest

Excludes: traumatic:
hemopneumothorax ( S27.2)
hemothorax ( S27.1)
pneumothorax ( S27.0)

S21.0 Open wound of the breast
S21.1 Open wound of the anterior chest wall
S21.2 Open wound of the posterior chest wall
S21.7 Multiple open chest wall wounds
S21.8 Open wound of other parts of the chest
S21.9 Open wound of unspecified thorax. Chest wall NOS

S22 Fracture of rib(s), sternum and thoracic spine

Included: thoracic region:
vertebral arches
spinous process
transverse process
vertebra
The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture or open wound; if the fracture is not characterized as open or closed, it should be classified as closed:
0 - closed
1 - open
Excludes: fracture:
clavicle ( S42.0 )
shoulder blades ( S42.1 )

S22.0 Fracture of the thoracic vertebrae. Fracture of thoracic spine NOS
S22.1 Multiple fractures of the thoracic spine
S22.2 Fracture of the sternum
S22.3 rib fracture
S22.4 Multiple rib fractures
S22.5 Retracted chest
S22.8 Fracture of other parts of the bone chest
S22.9 Fracture of unspecified part of bony thorax

S23 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the chest

Excludes: dislocation, sprain and strain of the sternoclavicular joint ( S43.2 , S43.6 )
rupture or displacement (non-traumatic) of the intervertebral disc in the thoracic region ( M51. -)

S23.0 Traumatic rupture of the intervertebral disc in the thoracic region
S23.1 Dislocation of the thoracic vertebrae. Thoracic spine NOS
S23.2 Dislocation of another and unspecified part of the chest
S23.3 Stretching and straining of the ligamentous apparatus of the thoracic spine
S23.4 Stretching and straining of the ligamentous apparatus of the ribs and sternum
S23.5 Stretching and straining of the ligamentous apparatus of another and unspecified part of the chest

S24 Injury of nerves and spinal cord in thoracic region

S14.3)

S24.0 Contusion and swelling of the thoracic spinal cord
S24.1 Other and unspecified injuries of thoracic spinal cord
S24.2 Injury to the nerve root of the thoracic spine
S24.3 Injury to the peripheral nerves of the chest
S24.4 Injury to the sympathetic nerves of the thoracic region. Heart plexus. Esophageal plexus. Pulmonary plexus. Star node. Thoracic sympathetic ganglion
S24.5 Injury to other nerves of the thoracic region
S24.6 Injury of the specified nerve of the thoracic region

S25 Injury of thoracic blood vessels

S25.0 Injury to the thoracic aorta. Aorta NOS
S25.1 Injury to the innominate or subclavian artery
S25.2 Injury to the superior vena cava. Vena cava NOS
S25.3 Injury to the innominate or subclavian vein
S25.4 Injury to the pulmonary blood vessels
S25.5 Injury to the intercostal blood vessels
S25.7 Injury to multiple blood vessels in the thoracic region
S25.8 Injury to other blood vessels in the thoracic region. Unpaired vein. Arteries or veins of the breast
S25.9 Injury to unspecified thoracic blood vessel

S26 Injury of the heart

Included: contusion)
gap)
puncture) of the heart
traumatic perforation)
The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture or open wound; if the fracture is not characterized as open or closed, it should be classified as closed:

S26.0 Injury to the heart with hemorrhage into the heart sac [hemopericardium]
S26.8 Other heart injuries
S26.9 Heart injury, unspecified

S27 Injury of other and unspecified organs of thoracic cavity

The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture or open wound; if the fracture is not characterized as open or closed, it should be classified as closed:
0 - no open wound in the chest cavity
1 - with an open wound in the chest cavity
Excludes: injury:
cervical esophagus ( S10-S19)
trachea (cervical) S10-S19)

S27.0 Traumatic pneumothorax
S27.1 Traumatic hemothorax
S27.2 Traumatic hemopneumothorax
S27.3 Other lung injuries
S27.4 Bronchial injury
S27.5 Thoracic tracheal injury
S27.6 Pleura injury
S27.7 Multiple injuries of the chest organs
S27.8 Injury to other specified organs of the thoracic cavity. diaphragms. Lymphatic thoracic duct
Esophagus (thoracic). thymus
S27.9 Injury to unspecified thoracic organ

S28 Crush of chest and traumatic amputation of part of chest

S28.0 Crushed chest
Excludes: loose chest ( S22.5)
S28.1 Traumatic amputation of a part of the chest
Excluded: transection of the trunk at the level of the chest ( T05.8)

S29 Other and unspecified injuries of chest

S29.0 Muscle and tendon injury at chest level
S29.7 Multiple chest injuries. Injuries classified by more than one of the rubrics S20-S29.0
S29.8 Other specified chest injuries
S29.9 Chest injury, unspecified

INJURIES OF THE ABDOMEN, LOWER BACK, LUMBAR SPINE AND PELVIS (S30-S39)

Included: injuries:
abdominal wall
anus
gluteal region
external genitalia
side of the abdomen
inguinal region
Excludes: thermal and chemical burns ( T20-T32)
the consequences of the penetration of a foreign body into:
anus and rectum T18.5)
urinary tract ( T19. -)
stomach, small and large intestines T18.2-T18.4)
vertebral fracture NOS ( T08)
frostbite ( T33-T35)
injuries:
back NOS ( T09. -)
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
bite or sting of a poisonous insect ( T63.4)

S30 Superficial injury of abdomen, lower back and pelvis

Excludes: superficial injury of the hip region ( S70. -)

S30.0 Contusion of the lower back and pelvis. Gluteal region
S30.1 Abdominal injury. Lateral abdomen. inguinal region
S30.2 Injury to the external genitalia. Labia (large) (small)
penis. Perineum. Scrotum. testicles. Vaginas. vulva
S30.7 Multiple superficial injuries of the abdomen, lower back and pelvis
S30.8 Other superficial injuries of the abdomen, lower back and pelvis
S30.9 Superficial trauma of the abdomen, lower back and pelvis, unspecified localization

S31 Open wound of abdomen, lower back and pelvis

Excludes: open wound of the hip joint ( S71.0)
traumatic amputation of a part of the abdomen, lower back and pelvis ( S38.2-S38.3)

S31.0 Open wound of the lower back and pelvis. Gluteal region
S31.1 Open wound of the abdominal wall. Lateral abdomen. inguinal region
S31.2 Open wound of the penis
S31.3 Open wound of the scrotum and testicles
S31.4 Open wound of the vagina and vulva
S31.5 Open wound of other and unspecified external genitalia
Excludes: traumatic amputation of vulva ( S38.2)
S31.7 Multiple open wounds of the abdomen, lower back and pelvis
S31.8 Open wound of other and unspecified part of abdomen

S32 Fracture of lumbosacral spine and pelvic bones

Includes: fracture at the level of the lumbosacral spine:
vertebral arches
spinous process
transverse process
vertebra
The following subcategories (fifth character) are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture or open wound; if the fracture is not characterized as open or closed, it should be classified as closed:
0 - closed
1 - open
Excludes: hip fracture NOS ( S72.0)

S32.0 Fracture of the lumbar vertebrae. Fracture of the lumbar spine
S32.1 sacrum fracture
S32.2 Tailbone fracture
S32.3 Fracture of the ilium
S32.4 Fracture of the acetabulum
S32.5 Fracture of the pubic bone
S32.7 Multiple fractures of the lumbosacral spine and pelvic bones
S32.8 Fractures of other and unspecified parts of the lumbosacral spine and pelvic bones
Fracture:
ischium
lumbosacral spine NOS
pelvis NOS

S33 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the lumbar spine and pelvis

Excludes: dislocation, sprain and strain of the hip joint and ligaments ( S73. -)
obstetric trauma of the joints and ligaments of the pelvis ( O71.6)
ruptures or displacement (non-traumatic) of the intervertebral disc in the lumbar region ( M51. -)

S33.0 Traumatic rupture of the intervertebral disc in the lumbosacral region
S33.1 Lumbar dislocation. Dislocation of lumbar spine NOS
S33.2 Dislocation of the sacroiliac joint and sacrococcygeal junction
S33.3 Dislocation of another and unspecified part of the lumbosacral spine and pelvis
S33.4 Traumatic rupture of the pubic symphysis [pubic joint]
S33.5 Stretching and straining of the capsular-ligamentous apparatus of the lumbar spine
S33.6 Sprain and strain of the capsular-ligamentous apparatus of the sacroiliac joint
S33.7 Stretching and straining of the capsular-ligamentous apparatus of another and unspecified part of the lumbosacral spine and pelvis

S34 Injury of nerves and lumbar spinal cord at the level of abdomen, lower back and pelvis

S34.0 Concussion and swelling of the lumbar spinal cord
S34.1 Other lumbar spinal cord injury
S34.2 Nerve root injury of the lumbosacral spine
S34.3 Cauda equina injury
S34.4 Injury of the lumbosacral nerve plexus
S34.5 Trauma to the lumbar, sacral, and pelvic sympathetic nerves
The celiac knot or plexus. Hypogastric plexus. Mesenteric plexus (lower) (upper). Visceral nerve
S34.6 Injury to the peripheral nerve(s) of the abdomen, lower back, and pelvis
S34.8 Injury to other and unspecified nerves at the level of the abdomen, lower back, and pelvis

S35 Injury of blood vessels at the level of abdomen, lower back and pelvis

S35.0 Abdominal aortic injury
Excludes: aortic injury NOS ( S25.0)
S35.1 Trauma of the inferior vena cava. hepatic vein
Excludes: trauma to vena cava NOS ( S25.2)
S35.2 Injury to the celiac or mesenteric artery. gastric artery
Gastroduodenal artery. hepatic artery. Mesenteric artery (inferior) (superior). splenic artery
S35.3 Injury to the portal or splenic vein. Mesenteric vein (inferior) (superior)
S35.4 Injury to the blood vessels of the kidney. Renal artery or vein
S35.5 Injury to the iliac blood vessels. hypogastric artery or vein. Iliac artery or vein
Arteries or veins of the uterus
S35.7 Injury to multiple blood vessels at the level of the abdomen, lower back, and pelvis
S35.8 Injury to other blood vessels at the level of the abdomen, lower back, and pelvis. Arteries or veins of the ovary
S35.9 Injury to an unspecified blood vessel at the level of the abdomen, lower back, and pelvis

S36 Injury of abdominal organs

S36.0 Spleen injury
S36.1 Injury to the liver or gallbladder. bile duct
S36.2 Trauma to the pancreas
S36.3 Stomach injury
S36.4 Injury to the small intestine
S36.5 Colon injury
S36.6 Rectal injury
S36.7 Trauma to multiple intra-abdominal organs
S36.8 Trauma to other intra-abdominal organs. Peritoneum. Retroperitoneal space
S36.9 Injury of unspecified intra-abdominal organ

S37 Injury of pelvic organs

The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to carry out multiple coding:
0 - no open wound in the abdominal cavity
1 - with an open wound in the abdominal cavity
Excludes: trauma of the peritoneum and retroperitoneal space ( S36.8)

S37.0 kidney injury
S37.1 Injury to the ureter
S37.2 Bladder injury
S37.3 Urethral trauma
S37.4 Ovarian injury
S37.5 Fallopian tube injury
S37.6 Uterus trauma
S37.7 Multiple trauma to the pelvic organs
S37.8 Trauma to other pelvic organs. Adrenal. prostate gland. seminal vesicles
vas deferens
S37.9 Injury of unspecified pelvic organ

S38 Crush and traumatic amputation of abdomen, lower back and pelvis

S38.0 Crushing of the external genitalia
S38.1 Crushing of other and unspecified parts of the abdomen, lower back and pelvis
S38.2 Traumatic amputation of the external genital organs
Labia (large) (small). penis. Scrotum. Testicles. vulva
S38.3 Traumatic amputation of other and unspecified abdomen, lower back and pelvis
Excluded: transection of the trunk at the level of the abdomen ( T05.8)

S39 Other and unspecified injuries of abdomen, lower back and pelvis

S39.0 Injury to the muscle and tendon of the abdomen, lower back, and pelvis
S39.6 Combined injury of intra-abdominal(s) and pelvic(s) organ(s)
S39.7 Other multiple abdominal, lower back, and pelvic injuries
Injuries classified by more than one of the rubrics S30-S39.6
Excludes: combination of injuries classified in rubric
S36. - with injuries classified under S37 . — (S39.6 )
S39.8 Other specified injuries of abdomen, lower back and pelvis
S39.9 Injury of abdomen, lower back and pelvis, unspecified

SHOULDER AND SHOULDER INJURIES (S40-S49)

Included: injuries:
armpit
scapular region
Excludes: bilateral injury of the shoulder girdle and shoulder ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
hands (unspecified location) ( T10-T11)
elbow ( S50 -S59 )
bite or sting of a poisonous insect ( T63.4)

S40 Superficial injury of shoulder girdle and shoulder

S40.0 Injury of the shoulder girdle and shoulder
S40.7 Multiple superficial injuries of the shoulder girdle and shoulder
S40.8 Other superficial injuries of the shoulder girdle and shoulder
S40.9 Superficial injury of shoulder girdle and shoulder, unspecified

S41 Open wound of shoulder girdle and upper arm

Excludes: traumatic amputation of the shoulder girdle and shoulder ( S48. -)

S41.0 Open wound of the shoulder girdle
S41.1 Open wound of the shoulder
S41.7 Multiple open wounds of the shoulder girdle and shoulder
S41.8 Open wound of other and unspecified part of shoulder girdle

S42 Fracture at the level of the shoulder girdle and shoulder

0 - closed
1 - open

S42.0 Clavicle fracture
Clavicles:
acromial end
body
sternal end
S42.1 Blade fracture. Acromial process. Acromion. Shoulder blades (body) (glenoid cavity) (neck)
Shoulder blade
S42.2 Fracture of the upper end of the humerus. anatomic neck. Big tubercle. proximal end
Surgical neck. Upper epiphysis
S42.3 Fracture of the body [diaphysis] of the humerus. Humerus NOS. Shoulder NOS
S42.4 Fracture of the lower end of the humerus. Articular process. distal end. External condyle
Internal condyle. Internal epicondyle. lower epiphysis. Supracondylar region
Excludes: fracture of elbow NOS ( S52.0)
S42.7 Multiple fractures of the clavicle, scapula and humerus
S42.8 Fracture of other parts of the shoulder girdle and shoulder
S42.9 Fracture of an unspecified part of the shoulder girdle. Shoulder fracture NOS

S43 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the shoulder girdle

S43.0 Dislocation of the shoulder joint. Glenohumeral joint
S43.1 Dislocation of the acromioclavicular joint
S43.2 Dislocation of the sternoclavicular joint
S43.3 Dislocation of another and unspecified part of the shoulder girdle. Dislocation of the shoulder girdle NOS
S43.4 Stretching and straining of the capsular-ligamentous apparatus of the shoulder joint
Coracohumeral (ligaments). Rotator cuff (capsule)
S43.5 Stretching and straining of the capsular-ligamentous apparatus of the acromioclavicular joint
Acromioclavicular ligament
S43.6 Stretching and straining of the capsular-ligamentous apparatus of the sternoclavicular joint
S43.7 Stretching and straining of the capsular-ligamentous apparatus of another and unspecified part of the shoulder girdle
Sprain and overstrain of the capsular-ligamentous apparatus of the shoulder girdle NOS

S44 Injury of nerves at the level of the shoulder girdle and shoulder

Excludes: brachial plexus injury ( S14.3)

S44.0 Ulnar nerve injury at shoulder level
Excludes: ulnar nerve NOS ( S54.0)
S44.1 Median nerve injury at shoulder level
Excludes: median nerve NOS ( S54.1)
S44.2 Radial nerve injury at shoulder level
Excludes: radial nerve NOS ( S54.2)
S44.3 Axillary nerve injury
S44.4 Musculocutaneous nerve injury
S44.5 Injury of the cutaneous sensory nerve at the level of the shoulder girdle and shoulder
S44.7 Injury to several nerves at the level of the shoulder girdle and shoulder
S44.8 Injury to other nerves at the level of the shoulder girdle and shoulder
S44.9 Injury to an unspecified nerve at the level of the shoulder girdle and shoulder

S45 Injury of blood vessels at level of shoulder girdle and upper arm

Excludes: subclavian injury:
arteries ( S25.1 )
veins ( S25.3 )

S45.0 Axillary artery injury
S45.1 Brachial injury
S45.2 Axillary or brachial vein injury
S45.3 Trauma of superficial veins at the level of the shoulder girdle and shoulder
S45.7 Injury to several blood vessels at the level of the shoulder girdle and shoulder
S45.8 Injury to other blood vessels at the level of the shoulder girdle and shoulder
S45.9 Injury to an unspecified blood vessel at the level of the shoulder girdle and upper arm

S46 Injury of muscle and tendon at shoulder girdle and shoulder level

Excludes: muscle and tendon injury at or below the elbow ( S56. -)

S46.0 Rotator cuff tendon injury
S46.1 Injury to the muscle and tendon of the long head of the biceps muscle
S46.2 Injury to the muscle and tendon of other parts of the biceps muscle
S46.3 Triceps muscle and tendon injury
S46.7 Injury to several muscles and tendons at the level of the shoulder girdle and shoulder
S46.8 Injury to other muscles and tendons at the level of the shoulder girdle and shoulder
S46.9 Injury of unspecified muscles and tendons at the level of the shoulder girdle and upper arm

S47 Crush of the shoulder girdle and shoulder

Excluded: crushed elbow ( S57.0)

S48 Traumatic amputation of shoulder girdle and shoulder

at elbow level S58.0)
upper limb at unspecified level ( T11.6)

S48.0 Traumatic amputation at the level of the shoulder joint
S48.1 Traumatic amputation at the level between the shoulder and elbow joints
S48.9 Traumatic amputation of the shoulder girdle and shoulder at an unspecified level

S49 Other and unspecified injuries of shoulder girdle and upper arm

S49.7 Multiple injuries of the shoulder girdle and shoulder
Injuries classified by more than one of the rubrics S40-S48
S49.8 Other specified injuries of the shoulder girdle and shoulder
S49.9 Injury of shoulder girdle and shoulder, unspecified

ELBOW AND FOREARM INJURIES (S50-S59)

Excludes: bilateral injury of elbow and forearm ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
hands at an unspecified level ( T10-T11)
wrists and hands S60-S69)
bite or sting of a poisonous insect ( T63.4)

S50 Superficial injury of forearm

Excludes: superficial injury of wrist and hand ( S60. -)

S50.0 Elbow bruise
S50.1 Contusion of other and unspecified part of the forearm
S50.7 Multiple superficial injuries of the forearm
S50.8 Other superficial injuries of the forearm
S50.9 Superficial injury of forearm, unspecified. Superficial injury of elbow NOS

S51 Open wound of forearm

Excludes: open wound of wrist and hand ( S61. -)
traumatic amputation of the forearm ( S58. -)

S51.0 Open wound of the elbow
S51.7 Multiple open wounds of the forearm
S51.8 Open wound of other parts of the forearm
S51.9 Open wound of unspecified part of forearm

S52 Fracture of bones of forearm

The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding for fracture and open wound; if the fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture at the level of the wrist and hand ( S62. -)

S52.0 Fracture of the upper end of the ulna. The coronoid process. Elbow NOS. Fracture dislocation Monteggi
Elbow. proximal end
S52.1 Fracture of the upper end of the radius. heads. Shakes. proximal end
S52.2 Fracture of the body [diaphysis] of the ulna
S52.3 Fracture of the body [diaphysis] of the radius
S52.4 Combined fracture of the diaphysis of the ulna and radius bones
S52.5 Fracture of the lower end of the radius. Collis fracture. Smith's fracture
S52.6 Combined fracture of the lower ends of the ulna and radius
S52.7 Multiple fractures of the bones of the forearm
Excludes: combined fracture of ulna and radius:
lower ends ( S52.6)
diaphyses ( S52.4)
S52.8 Fracture of other parts of the bones of the forearm. The lower end of the ulna. Ulnar heads
S52.9 Fracture of unspecified part of bones of forearm

S53 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the elbow joint

S53.0 Dislocation of the head of the radius. Shoulder joint
Excluded: fracture-dislocation of Monteggi ( S52.0)
S53.1 Elbow dislocation, unspecified. shoulder joint
Excluded: dislocation of the head of the radius only ( S53.0)
S53.2 Traumatic rupture of the radial collateral ligament
S53.3 Traumatic rupture of the ulnar collateral ligament
S53.4 Stretching and overstrain of the capsular-ligamentous apparatus of the elbow joint

S54 Injury of nerves at forearm level

Excludes: nerve injury at the level of the wrist and hand ( S64. -)

S54.0 Injury of the ulnar nerve at the level of the forearm. Ulnar nerve NOS
S54.1 Injury to the median nerve at the level of the forearm. Median nerve NOS
S54.2 Injury of the radial nerve at the level of the forearm. Radial nerve NOS
S54.3 Injury to the cutaneous sensory nerve at the level of the forearm
S54.7 Multiple nerve injury at forearm level
S54.8 Injury to other nerves at the level of the forearm
S54.9 Injury to an unspecified nerve at the level of the forearm

S55 Injury of blood vessels at forearm level

Excludes: injury:
blood vessels at the level of the wrist and hand ( S65. -)
blood vessels at shoulder level S45.1-S45.2)

S55.0 Injury of the ulnar artery at the level of the forearm
S55.1 Injury of the radial artery at the level of the forearm
S55.2 Vein injury at the level of the forearm
S55.7 Injury to multiple blood vessels at the level of the forearm
S55.8 Injury to other blood vessels at the level of the forearm
S55.9 Injury to unspecified blood vessel at forearm level

S56 Injury of muscle and tendon at forearm level

Excludes: injury to muscle and tendon at or below the level of the wrist ( S66. -)

S56.0 Injury of the flexor thumb and its tendon at the level of the forearm
S56.1 Injury of the flexor of the other finger(s) and its tendon at the level of the forearm
S56.2 Injury to another flexor and its tendon at the level of the forearm
S56.3 Injury to the extensor or abductor thumb and their tendons at the level of the forearm
S56.4 Injury of the extensor of the other finger(s) and its tendon at the level of the forearm
S56.5 Injury to other extensor and tendon at forearm level
S56.7 Injury to several muscles and tendons at the level of the forearm
S56.8 Injury to other and unspecified muscles and tendons at forearm level

S57 Crush of forearm

Excludes: crush injury of the wrist and hand ( S67. -)

S57.0 Crushing of the elbow joint
S57.8 Crushing of other parts of the forearm
S57.9 Crushing of an unspecified part of the forearm

S58 Traumatic amputation of forearm

S68. -)

S58.0 Traumatic amputation at the level of the elbow joint
S58.1 Traumatic amputation at the level between the elbow and radiocarpal joints
S58.9 Traumatic amputation of forearm, level unspecified

S59 Other and unspecified injuries of forearm

Excludes: other and unspecified injuries of wrist and hand ( S69. -)

S59.7 Multiple injuries to the forearm. Injuries classified by more than one of the rubrics S50-S58
S59.8 Other specified injuries of forearm
S59.9 Forearm injury, unspecified

INJURIES OF THE WRIST AND HAND (S60-S69)

Excludes: bilateral injury of wrist and hand ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
hand injury, level unspecified T10-T11)
bite or sting of a poisonous insect ( T63.4)

S60 Superficial injury of wrist and hand

S60.0 Contusion of the finger(s) of the hand without damage to the nail plate. Contusion of finger(s) of hand NOS
Excludes: contusion involving the nail plate ( S60.1)
S60.1 Contusion of the finger(s) of the hand with damage to the nail plate
S60.2 Bruising of other parts of the wrist and hand
S60.7 Multiple superficial injuries of the wrist and hand
S60.8 Other superficial injuries of the wrist and hand
S60.9 Superficial injury of wrist and hand, unspecified

S61 Open wound of wrist and hand

Excludes: traumatic amputation of wrist and hand ( S68. -)

S61.0 Open wound of the finger(s) of the hand without damage to the nail plate
Open wound of finger(s) NOS
Excludes: open wound involving the nail plate ( S61.1)
S61.1 Open wound of the finger(s) of the hand with damage to the nail plate
S61.7 Multiple open wounds of the wrist and hand
S61.8 Open wound of other parts of the wrist and hand
S61.9 Open wound of unspecified part of wrist and hand

S62 Fracture at wrist and hand level

The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture and an open wound; if the fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excludes: fracture of distal ends of ulna and radius ( S52. -)

S62.0 Fracture of the navicular bone of the hand
S62.1 Fracture of other bone(s) of the wrist. Capitate. Hook-shaped. Lunar. pisiform
Trapezoid [large polygonal]. Trapezoidal [small polygonal]. trihedral
S62.2 Fracture of the first metacarpal. Bennett's fracture
S62.3 Fracture of another metacarpal
S62.4 Multiple fractures of the metacarpal bones
S62.5 Fractured thumb
S62.6 Fracture of another finger
S62.7 Multiple finger fractures
S62.8 Fracture of other and unspecified part of wrist and hand

S63 Dislocation, sprain and strain of the capsular-ligamentous apparatus at the level of the wrist and hand

S63.0 Dislocation of the wrist. Wrist (bones). Carpometacarpal joint. Proximal end of the metacarpal
Mid-carpal joint. The wrist joint. Distal radioulnar joint
Distal end of the radius. Distal end of ulna
S63.1 Dislocation of the finger. Interphalangeal joint of the hand. Metacarpal bone of the distal end. Metacarpophalangeal joint
Phalanges of the brush. Thumb brush
S63.2 Multiple dislocations of fingers
S63.3 Traumatic rupture of the ligament of the wrist and metacarpus. Collateral ligament of the wrist
The radiocarpal ligament. Carpal (palmar) ligament
S63.4 Traumatic rupture of the ligament of the finger at the level of the metacarpophalangeal and interphalangeal joint(s)
Collateral. Palmar. Palmar aponeurosis
S63.5 Stretching and overstrain of the capsular-ligamentous apparatus at the level of the wrist. carpal (joint)
Wrist (joint) (ligaments)
S63.6 Stretching and overstrain of the capsular-ligamentous apparatus at the level of the finger
Interphalangeal joint of the hand. Metacarpophalangeal joint. Phalanges of the brush. Thumb brush
S63.7 Stretching and straining of the capsular-ligamentous apparatus of another and unspecified part of the hand

S64 Injury of nerves at wrist and hand level

S64.0 Ulnar nerve injury at wrist and hand level
S64.1 Median nerve injury at the level of the wrist and hand
S64.2 Injury to the radial nerve at the level of the wrist and hand
S64.3 thumb nerve injury
S64.4 Nerve injury to other finger
S64.7 Injury to multiple nerves at the level of the wrist and hand
S64.8 Injury to other nerves at the level of the wrist and hand
S64.9 Injury to an unspecified nerve at the level of the wrist and hand

S65 Injury of blood vessels at wrist and hand level

S65.0 Injury of the ulnar artery at the level of the wrist and hand
S65.1 Injury to the radial artery at the level of the wrist and hand
S65.2 Superficial palmar arch injury
S65.3 Deep palmar arch injury
S65.4 Injury to the blood vessel(s) of the thumb
S65.5 Injury to the blood vessel(s) of the other finger
S65.7 Injury to multiple blood vessels at the level of the wrist and hand
S65.8 Injury to other blood vessels at the level of the wrist and hand
S65.9 Injury to unspecified blood vessel at wrist and hand level

S66 Injury of muscle and tendon at wrist and hand level

S66.0 Injury of the long flexor of the thumb and its tendon at the level of the wrist and hand
S66.1 Injury of the flexor of the other finger and its tendon at the level of the wrist and hand
S66.2 Injury of the extensor thumb and its tendon at the level of the wrist and hand
S66.3 Injury of the extensor of the other finger and its tendon at the level of the wrist and hand
S66.4 Injury of the own muscle and tendon of the thumb at the level of the wrist and hand
S66.5 Injury of own muscle and tendon of another finger at the level of the wrist and hand
S66.6 Injury to several flexor muscles and tendons at the level of the wrist and hand
S66.7 Injury to several extensor muscles and tendons at the level of the wrist and hand
S66.8 Injury to other muscles and tendons at the level of the wrist and hand
S66.9 Injury of unspecified muscles and tendons at wrist and hand level

S67 Crush of wrist and hand

S67.0 Crushing of the thumb and other finger(s) of the hand
S67.8 Crushing of other and unspecified part of wrist and hand

S68 Traumatic amputation of wrist and hand

S68.0 Traumatic amputation of the thumb (complete) (partial)
S68.1 Traumatic amputation of the other one finger of the hand (complete) (partial)
S68.2 Traumatic amputation of two or more fingers (complete) (partial)
S68.3 Combined traumatic amputation of (part of) the finger(s) and other parts of the wrist and hand
S68.4 Traumatic amputation of the hand at the level of the wrist
S68.8 Traumatic amputation of other parts of the wrist and hand
S68.9 Traumatic amputation of wrist and hand, level unspecified

S69 Other and unspecified injuries of wrist and hand

S69.7 Multiple injuries of the wrist and hand. Injuries classified by more than one of the rubrics S60-S68
S69.8 Other specified injuries of the wrist and hand
S69.9 Wrist and hand injury, unspecified

INJURIES OF THE HIP AND HIP (S70-S79)

Excludes: bilateral hip and thigh injury ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
leg injury, level unspecified T12-T13)
bite or sting of a poisonous insect ( T63.4)

S70 Superficial injury of hip and thigh

S70.0 Contusion of the hip area
S70.1 Bruised hip
S70.7 Multiple superficial injuries of the hip and thigh area
S70.8 Other superficial injuries of the hip and thigh area
S70.9 Superficial injury of hip and thigh region, unspecified

S71 Open wound of hip and thigh

Excludes: traumatic amputation of the hip and thigh ( S78. -)

S71.0 Open wound of the hip area
S71.1 Open wound of the thigh
S71.7 Multiple open wounds of the hip and thigh area
S71.8 Open wound of other and unspecified part of pelvic girdle

S72 Fracture of femur

The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture and an open wound; if the fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open

S72.0 Fracture of the femoral neck. Fracture in the hip joint NOS
S72.1 Perforating fracture. Intertrochanteric fracture. trochanter fracture
S72.2 Subtrochanteric fracture
S72.3 Fracture of the body [diaphysis] of the femur
S72.4 Fracture of the lower end of the femur
S72.7 Multiple fractures of the femur
S72.8 Fractures of other parts of the femur

S72.9 Fracture of unspecified part of femur

S73 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the hip joint and pelvic girdle

S73.0 hip dislocation
S73.1 Stretching and straining of the capsular-ligamentous apparatus of the hip joint

S74 Injury of nerves at hip joint level

S74.0 Sciatic nerve injury at the level of the hip joint and thigh
S74.1 Femoral nerve injury at the level of the hip joint and thigh
S74.2 Injury of the cutaneous sensory nerve at the level of the hip joint and thigh
S74.7 Injury to multiple nerves at the level of the hip joint and thigh
S74.8 Injury to other nerves at the level of the hip joint and thigh
S74.9 Injury of unspecified nerve at the level of the hip joint and thigh

S75 Injury of blood vessels at hip and thigh level

Excludes: popliteal artery injury ( S85.0)

S75.0 Femoral artery injury
S75.1 femoral vein injury
S75.2 Trauma of the great saphenous vein at the level of the hip joint and thigh
Excludes: saphenous vein injury NOS ( S85.3)
S75.7 Injury to several blood vessels at the level of the hip joint and thigh
S75.8 Injury to other blood vessels at the level of the hip and thigh
S75.9 Injury to unspecified blood vessel at the level of the pelvic-femoral joint and thigh

S76 Injury of muscle and tendon at hip and thigh level

S76.0 Injury to the muscle and tendon of the hip joint
S76.1 Injury to the quadriceps muscle and its tendon
S76.2 Injury of the adductor muscle of the thigh and its tendon
S76.3 Muscle and tendon injury from the posterior muscle group at thigh level
S76.4 Injury to other and unspecified muscles and tendons at thigh level
S76.7 Injury to several muscles and tendons at the level of the hip joint and thigh

S77 Crushing of the hip joint and thigh

S77.0 Crushing of the hip area
S77.1 Hip crush
S77.2 Crushing of the hip and thigh area

S78 Traumatic amputation of hip and thigh

Excludes: traumatic amputation of leg, level unspecified ( T13.6)

S78.0 Traumatic amputation at the level of the hip joint
S78.1 Traumatic amputation at the level between the hip and knee joints
S78.9 Traumatic amputation of the hip joint and thigh at an unspecified level

S79 Other and unspecified injuries of hip and thigh

S79.7 Multiple injuries of the hip and thigh area
Injuries classified by more than one of the rubrics S70-S78
S79.8 Other specified injuries of the hip and thigh area
S79.9 Injury of the hip joint and thigh, unspecified

INJURIES OF KNEE AND SHIN (S80-S89)

Includes: ankle and ankle fracture
Excludes: bilateral injury of the knee and lower leg ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
ankle and foot, excluding ankle and ankle fracture ( S90-S99)
legs at unspecified level ( T12-T13)
bite or sting of a poisonous insect ( T63.4)

S80 Superficial injury of leg

Excludes: superficial injury of ankle and foot ( S90. -)

S80.0 Knee injury
S80.1 Contusion of other and unspecified part of lower leg
S80.7 Multiple superficial injuries of the lower leg
S80.8 Other superficial leg injuries
S80.9 Superficial injury of leg, unspecified

S81 Open wound of lower leg

Excludes: open wound of ankle and foot ( S91. -)
traumatic amputation of the lower leg ( S88. -)

S81.0 Open wound of the knee joint
S81.7 Multiple open wounds of the leg
S81.8 Open wound of other parts of the lower leg
S81.9 Open wound of shin, unspecified localization

S82 Fracture of tibia, including ankle joint

Includes: ankle fracture
The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture and an open wound; if the fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excludes: fracture of foot excluding ankle ( S92. -)

S82.0 Fracture of the patella. knee cup
S82.1 Fracture of the proximal tibia
Tibia:
condyles)
heads) with or without mention
proximal) mention of a fracture
tuberosity) fibula
S82.2 Fracture of the body [diaphysis] of the tibia
S82.3 Fracture of the distal tibia
With or without mention of fibula fracture
Excludes: inner [medial] ankle ( S82.5)
S82.4 Fracture of the fibula only
Excludes: lateral [lateral] malleolus ( S82.6)
S82.5 Fracture of the medial malleolus
Tibia with involvement:
ankle joint
ankles
S82.6 Fracture of the outer [lateral] ankle
Fibula involving:
ankle joint
ankles
S82.7 Multiple fractures of the leg
Excludes: concomitant fractures of the tibia and fibula:
lower end ( S82.3)
body [diaphysis] ( S82.2 )
top end ( S82.1)
S82.8 Fractures of other parts of the leg
Fracture:
ankle joint NOS
bimalleolar
trimalleolar
S82.9 Fracture of unspecified tibia

S83 Dislocation, sprain and strain of the capsular-ligamentous apparatus of the knee joint

Excluded: defeat:
internal ligament of the knee joint ( M23. -)
patella ( M22.0-M22.3)
dislocation of the knee joint:
outdated ( M24.3)
pathological ( M24.3)
repetitive [habitual] ( M24.4)

S83.0 Dislocation of the patella
S83.1 Dislocation of the knee joint. Tibiofibular joint
S83.2 fresh meniscus tear
Rupture of the horn according to the type of bucket handle:
NOS
outer [lateral] meniscus
inner [medial] meniscus
Excludes: old bucket-handle rupture of meniscus horn ( M23.2)
S83.3 Rupture of the articular cartilage of the knee joint fresh
S83.4 Sprain, rupture and strain of the (outer) (inner) lateral ligament
S83.5 Sprain, rupture and strain of the (anterior) (posterior) cruciate ligament of the knee joint
S83.6 Sprain, rupture and overstress of other and unspecified elements of the knee joint
Common ligament of the patella. tibiofibular syndesmosis and superior ligament
S83.7 Injury to multiple structures of the knee joint
Injury to the (outer) (inner) meniscus combined with injury to the (lateral) (cruciate) ligaments

S84 Injury of nerves at lower leg level

Excludes: nerve injury at ankle and foot level ( S94. -)

S84.0 Tibial nerve injury at the level of the leg
S84.1 Peroneal nerve injury at the level of the leg
S84.2 Injury of the cutaneous sensory nerve at the level of the lower leg
S84.7 Injury to several nerves at the level of the lower leg
S84.8 Injury to other nerves at the level of the lower leg
S84.9 Injury to an unspecified nerve at the level of the lower leg

S85 Injury of blood vessels at lower leg level

Excludes: injury to blood vessels at ankle and foot level ( S95. -)

S85.0 Popliteal artery injury
S85.1 Tibial (anterior) (posterior) artery injury
S85.2 Peroneal artery injury
S85.3 Injury to the great saphenous vein at the level of the lower leg. Great saphenous vein NOS
S85.4 Injury of the small saphenous vein at the level of the lower leg
S85.5 Popliteal vein injury
S85.7 Injury to several blood vessels at the level of the lower leg
S85.8 Injury to other blood vessels at the level of the lower leg
S85.9 Injury to unspecified blood vessel at leg level

S86 Injury of muscle and tendon at lower leg level

Excludes: muscle and tendon injury at ankle and foot level ( S96. -)

S86.0 Calcaneal [Achilles] tendon injury
S86.1 Injury to other muscle(s) and tendon(s) of the posterior muscle group at the level of the lower leg
S86.2 Injury to the muscle(s) and tendon(s) of the anterior muscle group at the level of the lower leg
S86.3 Injury to the muscle(s) and tendon(s) of the peroneal muscle group at the level of the lower leg
S86.7 Injury to several muscles and tendons at the level of the lower leg
S86.8 Injury to other muscles and tendons at the level of the lower leg
S86.9 Injury of unspecified muscles and tendons at leg level

S87 Crush of leg

Excludes: crush injury of ankle and foot ( S97. -)

S87.0 Crushing of the knee joint
S87.8 Crushing of other and unspecified part of lower leg

S88 Traumatic amputation of lower leg

Excludes: traumatic amputation:
ankle and foot ( S98. -)
lower limb, level unspecified ( T13.6)

S88.0 Traumatic amputation at the level of the knee joint
S88.1 Traumatic amputation at the level between the knee and ankle joints
S88.9 Traumatic amputation of lower leg, level unspecified

S89 Other and unspecified injuries of lower leg

Excludes: other and unspecified injuries of ankle and foot ( S99. -)

S89.7 Multiple leg injuries. Injuries classified by more than one of the rubrics S80-S88
S89.8 Other specified lower leg injuries
S89.9 Injury of leg, unspecified

INJURIES OF THE ANKLE AND FOOT (S90-S99)

Excludes: bilateral injury of ankle and foot ( T00-T07)
thermal and chemical burns and corrosion ( T20-T32)
ankle and ankle fracture S82. -)
frostbite ( T33-T35)
lower limb injury, level unspecified T12-T13)
bite or sting of a poisonous insect ( T63.4)

S90 Superficial injury of ankle and foot

S90.0 Ankle injury
S90.1 Contusion of the toe(s) without damage to the nail plate. Contusion of toe(s) NOS
S90.2 Contusion of the toe(s) with damage to the nail plate
S90.3 Contusion of other and unspecified part of the foot
S90.7 Multiple superficial injuries of the ankle and foot
S90.8 Other superficial injuries of the ankle and foot
S90.9 Superficial injury of ankle and foot, unspecified

S91 Open wound of ankle and foot

Excludes: traumatic amputation at ankle and foot level ( S98. -)

S91.0 Open wound of the ankle joint
S91.1 Open wound of the toe(s) without damage to the nail plate. Open wound of toe(s) NOS
S91.2 Open wound of the toe(s) with damage to the nail plate
S91.3 Open wound of other parts of the foot. Open wound of foot NOS
S91.7 Multiple open wounds of the ankle and foot

S92 Fracture of foot, excluding ankle fracture

The following subcategories are given for optional use in additional characterization of a condition where it is not possible or practical to perform multiple coding to identify a fracture and an open wound; if the fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture:
ankle joint ( S82. -)
ankles ( S82. -)

S92.0 Fracture of the calcaneus. Calcaneus. heels
S92.1 Fracture of the talus. Astragalus
S92.2 Fracture of other bones of the tarsus. cuboid
Wedge-shaped (intermediate) (internal) (external). Navicular bone of the foot
S92.3 Metatarsal bone fracture
S92.4 Fracture of the big toe
S92.5 Fracture of another toe
S92.7 Multiple fractures of the foot
S92.9 Fracture of foot, unspecified

S93 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the ankle joint and foot

S93.0 Dislocation of the ankle joint. Talus. Inferior end of fibula
The lower end of the tibia. In the subtalar joint
S93.1 Dislocation of the toe(s). Interphalangeal joint(s) of the foot. Metatarsophalangeal joint(s)
S93.2 Torn ligaments at the level of the ankle and foot
S93.3 Dislocation of another and unspecified part of the foot. Navicular bone of the foot. Tarsus (joints) (joints)
Tarsus-metatarsal joint(s)
S93.4 Sprain and strain of the ligaments of the ankle joint. Calcaneofibular ligament
Deltoid ligament. Internal lateral ligament. talofibular bone
Tibiofibular ligament (distal)
S86.0)
S93.5 Stretching and overstrain of the capsular-ligamentous apparatus of the joints of the toe(s) of the foot
Interphalangeal joint(s). Metatarsophalangeal joint(s)
S93.6 Sprain and overstrain of the capsular-ligamentous apparatus of other and unspecified joints of the foot
Tarsus (ligaments). Tarsus-metatarsal ligament

S94 Injury of nerves at ankle and foot level

S94.0 Injury to the external [lateral] plantar nerve
S94.1 Injury to the internal [medial] plantar nerve
S94.2 Deep peroneal nerve injury at ankle and foot level
Terminal lateral branch of the deep peroneal nerve
S94.3 Injury of the cutaneous sensory nerve at the level of the ankle joint and foot
S94.7 Multiple nerve injury at ankle and foot level
S94.8 Injury to other nerves at the level of the ankle and foot
S94.9 Injury of unspecified nerve at ankle and foot level

S95 Injury of blood vessels at ankle and foot level

Excludes: injury to posterior tibial artery and vein ( S85. -)

S95.0 Injury to the dorsal [dorsal] artery of the foot
S95.1 Injury to the plantar artery of the foot
S95.2 Dorsal [dorsal] vein injury
S95.7 Trauma to multiple blood vessels at the level of the ankle and foot
S95.8 Injury to other blood vessels at the level of the ankle and foot
S95.9 Injury to unspecified blood vessel at ankle and foot level

S96 Injury of muscle and tendon at ankle and foot level

Excludes: calcaneal [Achilles] tendon injury ( S86.0)

S96.0 Injury of the long flexor of the finger and its tendon at the level of the ankle joint and foot
S96.1 Injury of the long extensor of the finger and its tendon at the level of the ankle joint and foot
S96.2 Injury of own muscle and tendon at the level of the ankle joint and foot
S96.7 Injury to several muscles and tendons at the level of the ankle and foot
S96.8 Injury to another muscle and tendon at the level of the ankle and foot
S96.9 Injury of unspecified muscles and tendons at ankle and foot level

S97 Crush of ankle and foot

S97.0 Ankle crush
S97.1 Crush toe(s)
S97.8 Crushing of other parts of the ankle and foot. Foot crush NOS

S98 Traumatic amputation at ankle and foot level

S98.0 Traumatic amputation of the foot at the level of the ankle joint
S98.1 Traumatic amputation of one toe
S98.2 Traumatic amputation of two or more toes
S98.3 Traumatic amputation of other parts of the foot. Combined traumatic amputation of the toe(s) and other parts of the foot
S98.4 Traumatic amputation of foot, level unspecified

S99 Other and unspecified injuries of ankle and foot

S99.7 Multiple injuries of the ankle and foot
Injuries classified by more than one of the rubrics S90-S98
S99.8 Other specified ankle and foot injuries
S99.9 Injury of ankle and foot, unspecified