ICD-10 Coding for Achilles Tendinopathy(M76.61, M76.62, M76.60)
Complete ICD-10-CM coding and documentation guide for Achilles Tendinopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Achilles Tendinopathy
M76.6-M76.67Primary Range
Achilles tendinitis and bursitis
This range includes specific codes for Achilles tendinitis and bursitis, with laterality specifications.
Strain of Achilles tendon
These codes are used for acute strains of the Achilles tendon, specifying laterality.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M76.61 | Achilles tendinitis, right leg | Use when documentation specifies right leg Achilles tendinitis. |
|
| M76.62 | Achilles tendinitis, left leg | Use when documentation specifies left leg Achilles tendinitis. |
|
| M76.60 | Achilles tendinitis, unspecified leg | Use only when laterality is not documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for Achilles tendinopathy
Essential facts and insights about Achilles Tendinopathy
Primary ICD-10-CM Codes for achilles tendinopathy
Decision Criteria
clinical Criteria
- Pain localized >2 cm above calcaneal insertion
documentation Criteria
- Documentation specifies right leg
Applicable To
- Right Achilles tendinitis
Excludes
- Achilles tendon rupture (S86.011A)
Clinical Validation Requirements
- Pain localized >2 cm above calcaneal insertion
- Morning stiffness >30 min
- Negative Thompson test
Code-Specific Risks
- Incorrectly using when laterality is unspecified.
Coding Notes
- Ensure laterality is documented to avoid using unspecified codes.
M76.62 - Achilles tendinitis, left leg
Use when documentation specifies left leg Achilles tendinitis.
Applicable To
- Left Achilles tendinitis
Excludes
- Achilles tendon rupture (S86.012A)
Clinical Validation Requirements
- Pain localized >2 cm above calcaneal insertion
- Morning stiffness >30 min
- Negative Thompson test
Coding Notes
Ensure laterality is documented to avoid using unspecified codes.
M76.60 - Achilles tendinitis, unspecified leg
Use only when laterality is not documented.
Applicable To
- Unspecified Achilles tendinitis
Excludes
- Achilles tendon rupture (S86.011A, S86.012A)
Clinical Validation Requirements
- Generalized Achilles pain without specified laterality
Coding Notes
Query provider for laterality if possible.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Achilles tendinitis and bursitis
M76.6Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Achilles Tendinopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M76.61.
Impact
Clinical: Impacts treatment planning and follow-up., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Use templates that prompt for laterality, Educate staff on importance of specificity
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Query provider to specify affected side.
Impact
Inadequate documentation of laterality can lead to audit issues.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Achilles Tendinopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Achilles Tendinopathy
Use these documentation templates to ensure complete and accurate documentation for Achilles Tendinopathy. These templates include all required elements for proper coding and billing.
Chronic Achilles Tendinopathy
Specialty: PodiatryRequired Elements
- Location and laterality
- Onset and duration
- Imaging results
- Functional limitations
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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