New sprain codes are both described as “unspecified.” Find out what clues to look for.
You can use new ultrasound test codes 76881 (Ultrasound, extremity, nonvascular, real-time with image documentation; complete) and 76882 (Ultrasound, extremity, nonvascular, realtime with image documentation; limited, anatomic specific) to diagnose Achilles tendon tear. For an Achilles tendon tear that resulted from a traumatic event (such as coming down from a jump shot in basketball), you should report 845.09 (Sprains and strains of ankle and foot; ankle; other).
Effective October 2013, ICD-9 845.09 expands into two ICD-10 codes: S86.019A (Strain of unspecified Achilles tendon, initial encounter) and S93.499A (Sprain of other ligament of unspecified ankle, initial encounter).
ICD difference: The ICD-10 codes both describe unspecified areas of the strain, with S86.019A focusing on unspecified Achilles tendon. Meanwhile, S93.499A pertains to ligament of unspecified ankle.
Coder tips: Remember, S86.019A is specific for the Achilles tendon while S93.499A would include any ligament (doesn’t include tendon). Stay tuned to Podiatry Coding Alert for all ICD-10 updates.
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