S81.849A Puncture wound with foreign body, unspecified lower leg, initial encounter

ICD-10-CM Diagnosis Code S81.849A: Puncture Wound with Foreign Body, Unspecified Lower Leg, Initial Encounter

ICD-10-CM code S81.849A is an active terminology record classified as an injury or poisoning concept. It is identified as a billable code for a puncture wound with a foreign body in an unspecified lower leg during an initial encounter. Wound care billing guidance distinguishes this from lower leg puncture codes specifying laterality or lacking a foreign body. 1 5 3 4

Plain-language overview

The official terminology for S81.849A identifies a puncture wound with a foreign body in an unspecified lower leg during an initial encounter, and clinical literature notes penetrating injuries can present with suspected retained foreign bodies. 1 2

What this code represents

The official display label for S81.849A is puncture wound with foreign body, unspecified lower leg, initial encounter, and its semantic type is Injury or Poisoning. 1

S81.849A has an active record status and is designated as a billable code, while the terminology record also lists an abbreviation as puncture wound w foreign body, unsp lower leg, init encntr. 1 5

Coding details

In the ICD-10-CM hierarchy, S81.849A is a narrower concept under the parent code S81.849, which denotes a puncture wound with foreign body of an unspecified lower leg. 1

The terminology record lists S81.849A alongside S81.849D, which denotes a puncture wound with foreign body, unspecified lower leg, without specifying the encounter distinction between the two codes. 5

Documentation considerations

Clinical assessment of a puncture site involves a systematic physical examination and conventional radiographic investigation to identify retained objects, as non-radiopaque foreign bodies are frequently missed initially. 2

The risk of a retained foreign body is determined by the injury history, such as a splinter puncture wound with ongoing local tenderness, which guides the need for further diagnostic evaluation. 2

What the sources add

While S81.849A specifies an unspecified lower leg, wound care billing guidance contrasts this by listing distinct initial encounter codes for puncture wounds with foreign bodies in the right or left lower leg. 1 3

Wound care billing guidance also distinguishes puncture wounds with a foreign body from codes like S81.832A, which represents a puncture wound without a foreign body in the lower leg during an initial encounter. 3 4

Sources

1. ICD-10-CM S81.849A terminology record — National Cancer Institute Enterprise Vocabulary Services; accessed 2026-07-27.
2. My patient is injured: identifying foreign bodies with ultrasound — pmc.ncbi.nlm.nih.gov; accessed 2026-07-27.
3. Article - Billing and Coding: Wound Care (A55909) — cms.gov; accessed 2026-07-27.
4. Article - Billing and Coding: Wound Care (A55909) — cms.gov; accessed 2026-07-27.
5. Codigo. The #1 Billing Agency for Medical Practices — codigo.care; accessed 2026-07-27.