ICD-10-CM Diagnosis Code S31.63AD - Puncture wound of abdominal wall without foreign body, unspecified flank with penetration into peritoneal cavity, subsequent encounter (original) (raw)

S31.63AD is a billable diagnosis code used to specify a medical diagnosis of puncture wound of abdominal wall without foreign body, unspecified flank with penetration into peritoneal cavity, subsequent encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

S31.63AD is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like puncture wound of abdominal wall without foreign body unspecified flank with penetration into peritoneal cavity. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

Unspecified diagnosis codes like S31.63AD 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.