2025 ICD-10-CM code W50.4XXS

Sequela of an accidental scratch inflicted by another person.

This code should only be used for sequelae; the initial injury should be coded separately.Additional codes are needed to identify any co-morbidities or complications.

Modifiers may be applicable based on the circumstances of the visit (e.g., modifier -25 for significant and separately identifiable E/M service) or if the sequela requires separate procedures, such as debridement or surgical repair.

Medical necessity depends on the nature and severity of the sequela.Treatment for infection, significant scarring requiring intervention, or impairment of function would be medically necessary.Documentation must clearly support the need for treatment.

The clinical responsibility depends on the nature of the sequela.It could involve various specialties such as dermatology (for scarring), infectious disease (for infection), or plastic surgery (for reconstructive procedures).

IMPORTANT W50.4XXA (initial encounter), W50.4XXD (subsequent encounter)

In simple words: This code is for the long-term problems that happen after someone accidentally gets scratched by another person.

This ICD-10-CM code classifies the sequelae (late effects) resulting from an accidental scratch caused by another person.It is used to report the long-term consequences of the injury, not the initial event itself.The initial encounter would be coded differently using a code from the W50.4XXA series.This code is to be used in conjunction with codes from other chapters specifying the nature of the resulting condition (e.g., infection, scarring).

Example 1: A patient presents with a chronic, infected wound resulting from a scratch received three months prior during a playground altercation.The initial scratch was not medically treated.W50.4XXS would be used to code the sequela of infection.Additional codes would be required to specify the type of infection., A child is scratched on the face by a classmate during a school scuffle, resulting in a permanent scar.The code W50.4XXS would be used to describe the sequela of scarring. Additional codes would specify the location and nature of the scar., An adult involved in a physical altercation sustains a scratch that leads to keloid formation. The code W50.4XXS would be appropriate, supplemented by a code indicating the keloid formation.

Detailed history of the event, including date, mechanism of injury, and individuals involved. Documentation of the sequelae (e.g., infection, scarring, keloid formation).Photographs and imaging studies may be helpful in some cases.Any treatment received for the initial injury and any subsequent treatment for sequelae.

** Consider using additional codes to specify the type and location of the sequela, as well as any associated complications or co-morbidities.

  • Payment Status: Active
  • Specialties:Emergency Medicine, Dermatology, Infectious Disease, Plastic Surgery
  • Place of Service:Office, Emergency Room - Hospital, Urgent Care Facility
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