ICD-10 Coding for ATFL Sprain(S93.42XA)
Complete ICD-10-CM coding and documentation guide for ATFL Sprain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ATFL Sprain
S93.4Primary Range
Sprain and strain of ankle
This range includes codes for various ankle sprains, including the ATFL.
Key Information: ICD-10 code for ATFL sprain
Essential facts and insights about ATFL Sprain
Primary ICD-10-CM Code for atfl sprain
Decision Criteria
clinical Criteria
- Presence of ATFL tenderness and positive anterior drawer test
Applicable To
- Sprain of anterior talofibular ligament
Excludes
- Fracture of ankle (S82.-)
Clinical Validation Requirements
- Tenderness over ATFL
- Positive anterior drawer test
- MRI showing ATFL tear
Code-Specific Risks
- Using unspecified codes when ATFL is documented
Coding Notes
- Ensure documentation specifies the ligament involved and laterality.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of (healed) ligament injury
Z87.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Fracture of fibula
S82.8XXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting ATFL Sprain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S93.42XA.
Impact
Clinical: Inaccurate treatment planning, Regulatory: Non-compliance with coding guidelines, Financial: Potential claim denials
Mitigation Strategy
Always include laterality in documentation, Use templates that prompt for laterality
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Query provider for specific ligament involved.
Impact
High risk of audit if unspecified codes are used when specific documentation is available.
Mitigation Strategy
Ensure documentation is detailed and specific.
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 ATFL Sprain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ATFL Sprain
Use these documentation templates to ensure complete and accurate documentation for ATFL Sprain. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of ATFL sprain
Specialty: OrthopedicsRequired Elements
- Subjective: Patient history of injury
- Objective: Physical exam findings
- Assessment: Diagnosis of ATFL sprain
- Plan: Treatment and follow-up
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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