From the Research
The ICD-10 code for a subungual hematoma is S60.1- (Contusion of finger(s) with damage to nail). This code requires additional characters to specify which finger is affected and whether it's the right or left hand. For example, S60.11- would be used for a subungual hematoma of the thumb, while S60.12- through S60.15- would indicate other specific fingers. A seventh character is also needed to indicate if it's an initial encounter (A), subsequent encounter (D), or sequela (S). For instance, S60.11XA would represent an initial encounter for a subungual hematoma of the thumb. If the hematoma occurs on a toe rather than a finger, the appropriate code would be from the S90.1- series (Contusion of toe with damage to nail) 1.
Key Points to Consider
- Subungual hematomas form when blood collects under the nail following trauma, typically from crushing injuries or direct blows to the nail 2.
- Proper coding is essential for accurate medical documentation, appropriate billing, and tracking of these injuries in healthcare settings.
- The management of subungual hematoma, including the trephination procedure, is discussed in various studies, with potential complications, although rare, being reviewed 3, 4, 5.
- The outcome in terms of nail cosmesis does not appear to be affected by the mode of treatment, and the acutely painful subungual haematoma should be decompressed, whether this be done by trephining or nail removal 5.
Coding Specifications
- The ICD-10 code S60.1- is used for contusion of finger(s) with damage to nail.
- The code S90.1- is used for contusion of toe with damage to nail.
- Additional characters are required to specify the finger or toe affected and the encounter type (initial, subsequent, or sequela).
Clinical Implications
- Subungual hematomas can be caused by repetitive trauma in athletes, such as runners and dancers 2.
- The treatment of simple subungual hematomas by nail trephination alone is without cosmetic or infectious complications 3.
- The management of simple nail bed lacerations and subungual hematomas has remained somewhat controversial, with much debate surrounding the necessity of removing the nail plate for repair of a nail bed laceration versus trephination alone of a large subungual hematoma 4.