ICD-10 Coding for Lateral Epicondylitis(M77.11, M77.12)
Complete ICD-10-CM coding and documentation guide for Lateral Epicondylitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lateral Epicondylitis
M77.1-M77.12Primary Range
Lateral epicondylitis codes
These codes are used to identify lateral epicondylitis with specification of 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 |
|---|---|---|---|
| M77.11 | Lateral epicondylitis, right elbow | Use when the diagnosis of lateral epicondylitis is confirmed for the right elbow. |
|
| M77.12 | Lateral epicondylitis, left elbow | Use when the diagnosis of lateral epicondylitis is confirmed for the left elbow. |
|
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 right lateral epicondylitis
Essential facts and insights about Lateral Epicondylitis
Primary ICD-10-CM Codes for lateral epicondylitis
Decision Criteria
clinical Criteria
- Presence of lateral elbow pain with positive provocation tests
documentation Criteria
- Clear documentation of laterality and clinical findings
Applicable To
- Right lateral elbow tendinopathy
Excludes
- Medial epicondylitis (M77.0-)
Clinical Validation Requirements
- Pain at the lateral epicondyle of the right elbow
- Positive Cozen's test
- Imaging showing tendinosis at the ECRB origin
Code-Specific Risks
- Incorrect laterality documentation
- Lack of specific clinical findings
Coding Notes
- Ensure laterality is documented clearly to avoid unspecified coding.
M77.12 - Lateral epicondylitis, left elbow
Use when the diagnosis of lateral epicondylitis is confirmed for the left elbow.
Applicable To
- Left lateral elbow tendinopathy
Excludes
- Medial epicondylitis (M77.0-)
Clinical Validation Requirements
- Pain at the lateral epicondyle of the left elbow
- Positive Cozen's test
- Imaging showing tendinosis at the ECRB origin
Coding Notes
Ensure laterality is documented clearly to avoid unspecified coding.
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.
Medial epicondylitis
M77.0-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lateral Epicondylitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M77.11.
Impact
Clinical: Inaccurate diagnosis, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Document all relevant clinical tests, Include imaging results when applicable
Impact
Reimbursement: Potential claim denials or reduced reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Always specify laterality using M77.11 or M77.12
Impact
Using M77.10 without specifying laterality can trigger audits.
Mitigation Strategy
Always document and code laterality when known.
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 Lateral Epicondylitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lateral Epicondylitis
Use these documentation templates to ensure complete and accurate documentation for Lateral Epicondylitis. These templates include all required elements for proper coding and billing.
Initial evaluation of lateral epicondylitis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis and treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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