S61.459A (Open bite of unspecified hand, initial encounter) compared with S61.459D (Open bite of unspecified hand, subsequent encounter), from the official CMS tabular data. S61.459A and S61.459D code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S61.459A and S61.459D code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| S61.459AOpen bite of unspecified hand, initial encounter | S61.459DOpen bite of unspecified hand, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| 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 bite of unspecified hand, initial encounter is a billable ICD-10-CM diagnosis code (S61.459A). | Open bite of unspecified hand, subsequent encounter is a billable ICD-10-CM diagnosis code (S61.459D). |
| 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 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources