S61.0 vs S61.230

S61.0 (Open wound of thumb without damage to nail) compared with S61.230 (Puncture wound without foreign body of right index finger without damage to nail), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because S61.230 lists S61.0 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

Title wording.The titles share “without damage to nail”; S61.0 says “Open wound of thumb” where S61.230 says “Puncture wound without foreign body of right index finger”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.S61.230 lists S61.0 under Excludes2: “open wound of thumb without damage to nail (S61.0-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. S61.0 carries 3 Excludes1 notes and S61.230 carries 3 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.S61.230’s tabular entry: “open wound of thumb without damage to nail (S61.0-)”. The note covers S61.0.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category S61.

Registry fact

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

S61.230

Puncture wound without foreign body of right index finger without damage to nail

↔

S61.0

Open wound of thumb without damage to nail

What we found

Yes, when both are documented.S61.230 carries an Excludes2 note covering S61.0: “open wound of thumb without damage to nail (S61.0-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	S61.0Open wound of thumb without damage to nail	S61.230Puncture wound without foreign body of right index finger without damage to nail
Billing status	Non-billable header Report instead: S61.001A, S61.001D, S61.001S, S61.002A, S61.002D	Non-billable header Report instead: S61.230A, S61.230D, S61.230S
Classification	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
Definition	Open wound of thumb without damage to nail is a non-billable ICD-10-CM category code (S61.0).	Puncture wound without foreign body of right index finger without damage to nail is a non-billable ICD-10-CM category code (S61.230).
7th character	The appropriate 7th character is to be added to each code from category S61	The appropriate 7th character is to be added to each code from category S61
Excludes1	open wound of thumb with damage to nail (S61.1-) open fracture of wrist, hand and finger (S62.- with 7th character B) traumatic amputation of wrist and hand (S68.-)	open wound of finger involving nail (matrix) (S61.3-) open fracture of wrist, hand and finger (S62.- with 7th character B) traumatic amputation of wrist and hand (S68.-)
Excludes2	burns and corrosions (T20-T32) frostbite (T33-T34) insect bite or sting, venomous (T63.4)	open wound of thumb without damage to nail (S61.0-) burns and corrosions (T20-T32) frostbite (T33-T34) insect bite or sting, venomous (T63.4)
Code also	any associated wound infection	any associated wound infection

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources