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S71.13 vs S91

S71.13 (Puncture wound without foreign body of thigh) compared with S91 (Open wound of ankle, foot and toes), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because S71.13 lists S91 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named.S71.13 is “Puncture wound without foreign body of thigh”; S91 is “Open wound of ankle, foot and toes”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.S71.13 lists S91 under Excludes2: “open wound of ankle, foot and toes (S91.-)”. 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. S71.13 carries 2 Excludes1 notes and S91 carries 2 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.S71.13’s tabular entry: “open wound of ankle, foot and toes (S91.-)”. The note covers S91.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

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

S71.13
Puncture wound without foreign body of thigh
↔
S91
Open wound of ankle, foot and toes

What we found

Yes, when both are documented.S71.13 carries an Excludes2 note covering S91: “open wound of ankle, foot and toes (S91.-)”

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 Excludes2Check 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 FY2026

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

S71.13Puncture wound without foreign body of thighS91Open wound of ankle, foot and toes
Billing statusNon-billable header

Report instead: S71.131A, S71.131D, S71.131S, S71.132A, S71.132D

Non-billable header

Report instead: S91.001A, S91.001D, S91.001S, S91.002A, S91.002D

ClassificationS00-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)
DefinitionPuncture wound without foreign body of thigh is a non-billable ICD-10-CM category code (S71.13).Open wound of ankle, foot and toes is a non-billable ICD-10-CM category code (S91).
7th characterThe appropriate 7th character is to be added to each code from category S71The appropriate 7th character is to be added to each code from category S91
Excludes1
open fracture of hip and thigh (S72.-)
traumatic amputation of hip and thigh (S78.-)
open fracture of ankle, foot and toes (S92.-with 7th character B)
traumatic amputation of ankle and foot (S98.-)
Excludes2
bite of venomous animal (T63.-)
open wound of ankle, foot and toes (S91.-)
open wound of knee and lower leg (S81.-)
burns and corrosions (T20-T32)
frostbite (T33-T34)
snake bite (T63.0-)
venomous insect bite or sting (T63.4-)
burns and corrosions (T20-T32)
fracture of ankle and malleolus (S82.-)
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 (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources