ICD-10 Coding for Right Hamstring Strain(S76.311A, S76.311D)
Complete ICD-10-CM coding and documentation guide for Right Hamstring Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Hamstring Strain
S76.3Primary Range
Injury of muscle and tendon at thigh level
This range includes codes for strains of the posterior muscle group of the thigh, including the right hamstring.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S76.311A | Strain of muscle, fascia and tendon of posterior muscle group at thigh level, right thigh, initial encounter | Use for initial encounter of an acute right hamstring strain. |
|
| S76.311D | Strain of muscle, fascia and tendon of posterior muscle group at thigh level, right thigh, subsequent encounter | Use for follow-up visits after the initial treatment of a right hamstring strain. |
|
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 hamstring strain
Essential facts and insights about Right Hamstring Strain
Primary ICD-10-CM Codes for right hamstring strain
Decision Criteria
clinical Criteria
- Presence of acute pain and tenderness in the right posterior thigh
documentation Criteria
- Documentation must specify laterality and encounter type
Applicable To
- Acute right hamstring strain
Excludes
- Sprain of ligament (S83.6-)
Clinical Validation Requirements
- Sudden posterior thigh pain
- Tenderness and reduced strength in right thigh
- MRI showing musculotendinous edema
Code-Specific Risks
- Incorrect laterality
- Missing 7th character for encounter type
Coding Notes
- Ensure documentation specifies 'right' and 'initial encounter' to avoid unspecified codes.
S76.311D - Strain of muscle, fascia and tendon of posterior muscle group at thigh level, right thigh, subsequent encounter
Use for follow-up visits after the initial treatment of a right hamstring strain.
Applicable To
- Follow-up care for right hamstring strain
Excludes
- Initial encounter (S76.311A)
Clinical Validation Requirements
- Ongoing rehabilitation
- Resolved pain but functional deficits
Coding Notes
Ensure the encounter type is clearly documented as subsequent.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Muscle weakness (generalized)
M62.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Sprain of ligaments of knee
S83.6-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Hamstring Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S76.311A.
Impact
Clinical: Misclassification of the injury type., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential for claim denials.
Mitigation Strategy
Educate providers on the difference between sprains and strains.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding standards., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always specify laterality and encounter type in documentation.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation specifies laterality and encounter type.
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 Hamstring Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Hamstring Strain
Use these documentation templates to ensure complete and accurate documentation for Right Hamstring Strain. These templates include all required elements for proper coding and billing.
Acute Injury Evaluation
Specialty: Sports MedicineRequired Elements
- History of injury
- 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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