ICD-10 Coding for Knee Strain(S76.011, S76.012)
Complete ICD-10-CM coding and documentation guide for Knee Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Knee Strain
S76.0-S76.02Primary Range
Strain of muscle, fascia and tendon of thigh
This range includes codes for strains of the thigh muscles, which are the primary focus for knee strain injuries.
Iliotibial band syndrome
This range is relevant for chronic overuse injuries related to knee 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 |
|---|---|---|---|
| S76.011 | Strain of right anterior thigh muscle, fascia and tendon | Use for acute traumatic injury to the right anterior thigh muscle. |
|
| S76.012 | Strain of left anterior thigh muscle, fascia and tendon | Use for acute traumatic injury to the left anterior thigh muscle. |
|
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 knee strain
Essential facts and insights about Knee Strain
Primary ICD-10-CM Codes for knee strain
Decision Criteria
clinical Criteria
- Sudden onset of pain during activity with palpable defect in muscle
documentation Criteria
- Specify anterior vs. posterior muscle involvement
Applicable To
- Quadriceps strain
Excludes
- Sprain of knee ligaments (S83.5-)
Clinical Validation Requirements
- MRI showing edema in quadriceps tendon
- Physical exam indicating pain on resisted knee extension
Code-Specific Risks
- Confusion with knee ligament sprain codes
Coding Notes
- Ensure documentation specifies laterality and muscle group.
S76.012 - Strain of left anterior thigh muscle, fascia and tendon
Use for acute traumatic injury to the left anterior thigh muscle.
Applicable To
- Quadriceps strain
Excludes
- Sprain of knee ligaments (S83.5-)
Clinical Validation Requirements
- MRI showing edema in quadriceps tendon
- Physical exam indicating pain on resisted knee extension
Coding Notes
Ensure documentation specifies laterality and muscle group.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Knee Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S76.011.
Impact
Clinical: Ambiguity in treatment plan, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always document the side of the body affected, Use templates that prompt for laterality
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Differentiate using imaging results and specific clinical findings.
Impact
Risk of audits due to lack of specificity in muscle strain coding.
Mitigation Strategy
Use detailed documentation templates and confirm with imaging.
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 Knee Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Knee Strain
Use these documentation templates to ensure complete and accurate documentation for Knee Strain. These templates include all required elements for proper coding and billing.
Acute knee strain during sports
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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