T81.41XS
ICD-10-CMInfection following a procedure, superficial incisional surgical site, sequela
This code signifies a localized infection affecting only the skin and subcutaneous tissue at the site of a surgical incision, occurring as a long-term complication or late effect. It indicates that the acute phase of the infection has passed, and the patient is now experiencing the residual effects or consequences of that prior infection. This is distinct from an active, acute infection.
Use this code when documenting a patient presenting with sequelae (e.g., chronic drainage, non-healing wound, scar tissue complications, or persistent pain) directly attributable to a superficial incisional surgical site infection that occurred in the past. This code is appropriate for follow-up encounters addressing these long-term effects, not for the initial treatment of the acute infection.
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