ICD-10 Coding for Right Elbow Injury(S53.401A, S52.201A, M77.01)
Complete ICD-10-CM coding and documentation guide for Right Elbow Injury. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Elbow Injury
S50-S59Primary Range
Injuries to the elbow and forearm
This range includes specific codes for various types of elbow injuries, including fractures, sprains, and strains.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S53.401A | Sprain of unspecified ligament of right elbow, initial encounter | Use when there is a confirmed UCL sprain with positive valgus stress test. |
|
| S52.201A | Fracture of upper end of right radius, initial encounter for closed fracture | Use when imaging confirms a radial head fracture. |
|
| M77.01 | Lateral epicondylitis, right elbow | Use when pain is localized to the lateral epicondyle with positive Cozen's test. |
|
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 elbow injury
Essential facts and insights about Right Elbow Injury
Primary ICD-10-CM Codes for right elbow injury
Decision Criteria
clinical Criteria
- Valgus instability on stress testing
Applicable To
- UCL sprain
Excludes
- Medial epicondylitis
Clinical Validation Requirements
- Valgus stress test >3mm laxity on MRI
Code-Specific Risks
- Risk of using unspecified codes when specific ligament involvement is known.
Coding Notes
- Ensure laterality is documented correctly.
S52.201A - Fracture of upper end of right radius, initial encounter for closed fracture
Use when imaging confirms a radial head fracture.
Applicable To
- Radial head fracture
Excludes
- Open fracture
Clinical Validation Requirements
- Tenderness over radial head with positive elbow extension test
Coding Notes
Document imaging findings to support fracture diagnosis.
M77.01 - Lateral epicondylitis, right elbow
Use when pain is localized to the lateral epicondyle with positive Cozen's test.
Applicable To
- Tennis elbow
Excludes
- Medial epicondylitis
Clinical Validation Requirements
- Pain reproduction on resisted middle finger extension
Coding Notes
Ensure differentiation from medial epicondylitis.
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 Right Elbow Injury to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S53.401A.
Impact
Clinical: Can lead to incorrect treatment plans., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always specify left or right in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available based on clinical findings.
Impact
Use of unspecified codes when specific codes are available.
Mitigation Strategy
Regular training on code specificity and documentation requirements.
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 Right Elbow Injury, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Elbow Injury
Use these documentation templates to ensure complete and accurate documentation for Right Elbow Injury. These templates include all required elements for proper coding and billing.
Orthopedic Follow-Up
Specialty: OrthopedicsRequired Elements
- Subjective pain assessment
- Objective range of motion
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Right Elbow Injury? Ask your questions below.