ICD-10 code S31.142S: Abdominal puncture wound sequela

Key takeaways

ICD-10 code S31.142S describes a puncture wound of the abdominal wall with foreign body, epigastric region, without penetration into the peritoneal cavity, sequela

S31.142S is a billable ICD-10-CM code valid for reimbursement. Its parent code, S31.142, is non-billable and cannot be submitted to payers.

The 7th character S designates a sequela, or late effect, encounter. It means the patient is being treated for a condition caused by a prior puncture wound, not the original injury itself.

Pabau’s claims management software helps coders track encounter-type documentation and submit the correct 7th character code without manual lookup errors

ICD-10 code S31.142S is a billable, specific ICD-10-CM diagnosis code that can be used to indicate a diagnosis for reimbursement purposes. It is valid for encounters on or after October 1, 2025, as part of the 2026 edition of ICD-10-CM. The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) maintain the code set jointly.

The full official description is: Puncture wound of abdominal wall with foreign body, epigastric region, without penetration into peritoneal cavity, sequela. Every word in that description is a coding qualifier. Remove any one of them from the clinical record and the code no longer applies. The same qualifier-driven logic applies to puncture wounds in adjacent regions, such as S31.804A for the buttock.

The code must be used exactly as documented by the treating clinician. Coders cannot infer peritoneal penetration or foreign body presence from the clinical picture alone. Both must appear explicitly in the provider’s documentation.

Clinical description: Puncture wound with foreign body, no peritoneal penetration

S31.142S captures four clinical specifics simultaneously. Each must be documented for the code to apply.

• Puncture wound: A penetrating injury caused by a sharp, narrow object (knife, needle, glass fragment, metal shard). Distinguished from open wounds, lacerations, and abrasions by its mechanism and depth.
• Foreign body present: The record must note a foreign body in the wound. It may be retained at treatment or removed but documented as part of the original injury history. Absence of this notation requires a different code without the “with foreign body” qualifier.
• Epigastric region: This anatomical site sits in the upper central abdomen, below the sternum and above the umbilicus, between the costal margins. Structures in this zone include the stomach, pylorus, duodenum, pancreas, and part of the liver.
• No penetration into the peritoneal cavity: The wound stays within the abdominal wall and does not breach the peritoneum. This is a major clinical qualifier. Wounds that do breach the peritoneal cavity fall under the separate S31.6 category, not S31.1.
• Sequela encounter: The patient is presenting for treatment of a late effect arising from the original abdominal injury, not for the injury itself. Examples include adhesions, herniation, chronic pain, or fistula formation following the original puncture.

Coders reviewing healthcare compliance documentation standards will recognize this pattern. Specificity in documentation directly determines which code applies, and vague operative notes or discharge summaries create coding ambiguity that auditors flag. For practices managing surgical or urgent-care workflows, this is where claims management software helps teams catch missing clinical qualifiers before submission.

Understanding the 7th character: A, D, and S encounter types for S31.142

S31.142 is a non-billable parent code. Coders must select one of its three billable child codes using the 7th character to specify the encounter type. This is one of the most frequently misapplied rules in trauma coding. The AAPC Codify ICD-10-CM lookup and the ICD-10-CM Official Guidelines for Coding and Reporting confirm the distinction.

What “sequela” means in ICD-10 coding

A sequela encounter type in ICD-10-CM applies when the original condition has resolved but has left a residual effect requiring treatment. The 7th character S applies once the original wound has fully healed. The late effect it caused, not the wound itself, is now the reason for the visit.

Coding sequelae correctly requires two codes in most cases. The sequela code (S31.142S) serves as the primary diagnosis, followed by a code for the specific late effect, such as abdominal adhesion or scar formation. The original injury code is sequenced after the sequela-effect code, not before it. This sequencing rule is defined in Section I.C.19 of the ICD-10-CM Official Guidelines for Coding and Reporting. The same rule applies to sibling codes such as S31.010A.

Billable status and reimbursement use

S31.142S is a valid billable code accepted for reimbursement under ICD-10-CM. Its parent code S31.142 is non-billable. Payers will reject a claim submitted with the six-character parent because it lacks the specificity required for a valid diagnosis submission. The CDC/NCHS ICD-10-CM web tool confirms billable status by code year. It shows that S31.142S remains active for the 2026 edition.

Practices using claims management software can configure validation rules that flag parent codes missing a 7th character extension. That stops the denial before the claim leaves the practice. Alongside claims management, patient data management systems that store injury history help coders retrieve the original encounter documentation. That documentation matters when assigning sequela codes months after the initial visit.

Code hierarchy and parent codes for S31.142S

Understanding where S31.142S sits in the ICD-10-CM hierarchy helps coders navigate the tabular list. It also guides which adjacent code to select when documentation does not fully support the most specific level.

Practices that manage surgical practice workflows encounter codes from this chapter regularly. Having a system that stores injury history and generates encounter-appropriate code suggestions reduces manual lookups across a complex tabular hierarchy like S00-T88.

Related and sibling codes

S31.142S sits within a family of codes that share most qualifiers but differ in anatomical site, side, or presence of peritoneal penetration. Selecting the wrong sibling code is a common audit finding. The ICD List lookup tool provides a free search across sibling and adjacent codes with their descriptions.

The most common coding error in this sibling group is using S31.132S, which has no foreign body qualifier. That happens when a foreign body was present but not carried through to the sequela encounter note. The sequela note does not need to re-describe the foreign body in detail. A brief reference to the original injury is enough. The record just needs to link back to the initial encounter documentation where the foreign body was noted.

Coding guidelines and clinical documentation for S31.142S

Four documentation requirements protect the reimbursability of S31.142S. Each must be present in the record before the coder assigns this specific code.

• The record must not describe peritoneal penetration: S31.142S applies only when the wound stays confined to the abdominal wall. If the clinician’s note, operative report, or imaging interpretation states that the peritoneal cavity was entered, code the encounter under the separate S31.6 series instead.
• Foreign body history must be documented: Note whether the foreign body was removed at the initial encounter or tracked as part of the injury history. Either the original encounter note or a clinical summary referenced in the sequela visit note must mention the foreign body. A sequela note that omits foreign body history defaults the coder to S31.132S.
• Sequela sequencing rules apply: Per Section I.C.19 of the ICD-10-CM Official Guidelines, list the sequela condition first, such as adhesion of peritoneum coded separately. The injury code with the S suffix follows it. At the sequela visit, the late effect is the principal diagnosis, not the injury code (S31.142S).
• Accurate encounter-type assignment: Assign S31.142S only when the original wound is resolved. If any active wound treatment is still occurring (dressing changes, ongoing debridement, irrigation), use S31.142D instead. The transition from D to S is a clinical judgment made by the treating provider, not the coder.

Practices using clinical records management systems that link historical encounter data to current visits give coders a significant advantage here. When the original S31.142A encounter note is retrievable at the sequela visit, coders can verify foreign body documentation and peritoneal penetration language. They can also confirm injury resolution status without requesting the chart separately.

Structured digital documentation forms at the initial encounter that capture these qualifiers in structured fields reduce the ambiguity that causes sequela coding errors later. For practices navigating clinical documentation compliance requirements, having an audit trail across the full injury episode is equally valuable for payer audits and HIPAA-compliant record-keeping.

How Pabau supports abdominal wound coding and documentation

Coders tracking puncture wound episodes often juggle separate records for the original encounter, any follow-up visits such as physical therapy, and the eventual sequela visit. Without a linked chart, confirming the epigastric location, the foreign-body history, and the encounter type before assigning S31.142S means requesting the original notes every time.

Practice management software like Pabau keeps the initial S31.142A encounter, any S31.142D follow-ups, and the later sequela visit inside one patient record. Coders can then confirm foreign-body documentation and check that no peritoneal penetration was recorded without pulling a separate chart. Pabau’s claims management software also flags a submitted parent code that is missing its 7th character before the claim leaves the practice.

The result is fewer denials tied to encounter-type mismatches, and faster sequela coding when the original treating provider is no longer part of the practice.

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Conclusion

Sequela coding for abdominal puncture wounds is high-stakes. A missed foreign-body notation or an incorrectly assigned encounter type between D and S creates denials. Those denials are difficult to correct retrospectively, especially once the original treating provider is no longer involved in the follow-up visit.

Pabau’s compliance management tools and claims workflow make sequela coding defensible through structured injury history capture, cross-visit record linking, and pre-submission code validation. To see how Pabau supports injury episode documentation across your practice, book a demo.

Continue your research

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