ICD-10 Coding for Achilles Tendon Strain(S86.011A, S86.012A)
Complete ICD-10-CM coding and documentation guide for Achilles Tendon Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Achilles Tendon Strain
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S86.011A | Strain of right Achilles tendon, initial encounter | Use for acute strain of the right Achilles tendon during the initial encounter. |
|
| S86.012A | Strain of left Achilles tendon, initial encounter | Use for acute strain of the left Achilles tendon during the initial encounter. |
|
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 tendon strain
Essential facts and insights about Achilles Tendon Strain
Primary ICD-10-CM Codes for achilles tendon strain
Decision Criteria
clinical Criteria
- Acute pain and swelling in the Achilles region with a positive Thompson test.
documentation Criteria
- Document mechanism of injury and confirm laterality.
Applicable To
- Acute strain of right Achilles tendon
Excludes
- Achilles tendinitis (M76.6)
Clinical Validation Requirements
- MRI or ultrasound showing peritendinous edema without tear
- Positive Thompson test
Code-Specific Risks
- Misclassification with tendinitis
- Omitting laterality
Coding Notes
- Ensure laterality and encounter type are documented.
S86.012A - Strain of left Achilles tendon, initial encounter
Use for acute strain of the left Achilles tendon during the initial encounter.
Applicable To
- Acute strain of left Achilles tendon
Excludes
- Achilles tendinitis (M76.6)
Clinical Validation Requirements
- MRI or ultrasound showing peritendinous edema without tear
- Positive Thompson test
Coding Notes
Ensure laterality and encounter type are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fall from curb, initial encounter
W00.0XXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Achilles Tendon Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S86.011A.
Impact
Clinical: Leads to incomplete clinical records., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always specify right or left in the documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification affects compliance with coding standards., Data Quality: Impacts the accuracy of patient records.
Mitigation Strategy
Use S86.0 codes for acute strains and M76.6 for chronic tendinitis.
Impact
Failure to document laterality can lead to coding errors.
Mitigation Strategy
Implement a checklist to ensure laterality is always documented.
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 Tendon Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Achilles Tendon Strain
Use these documentation templates to ensure complete and accurate documentation for Achilles Tendon Strain. These templates include all required elements for proper coding and billing.
Acute Achilles Tendon Strain
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Physical exam findings
- Imaging results
- Diagnosis with laterality
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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