There has been some confusion on Sprain vs. Strain and how to find them in ICD-10-CM. They are now split in two separate code ranges and Injury is now related to the anatomic location specific to the injury.
It will help to remember the following information when searching for Strains vs. Sprains
Injuries are listed by site or location, for the next two examples we will look at S6- Wrist, hand, fingers and S4- Shoulder/upper arm.
|3||Abdomen, lumbar spine and pelvis (S30-S39)|
|4||Shoulder/upper arm (S40-S49)|
|6||Wrist, hand, fingers (S60-S69)
|8||Knee/lower leg (S80-S89)|
|9||Ankle, foot, toes (S90-S99)|
Search for: Strain of the Flexor tendon of the right index finger
S Ch. 19 Injury, poisoning and certain other consequences of external causes (S00-T88)
S6 Injuries to the wrist hand and fingers (S60-S69)
S66 Injury of muscle, fascia and tendon at wrist and hand level
S66.1 Injury of flexor muscle, fascia and tendon of other and unspecified finger at wrist and hand level
S66.11 Strain of flexor muscle, fascia and tendon of other and unspecified finger at wrist and hand level
S66.110 Strain of flexor muscle, fascia and tendon of right index finger at wrist and hand level
S66.110A Strain of flexor muscle, fascia and tendon of right index finger at wrist and hand level, initial encounter
Take a look at a rotator cuff tear. If the injury is reported as a Sprain of rotator cuff capsule it is reported with the a code from S43.42-
S4 Injury Shoulder/Upper Arm
S43 Dislocation and sprain of joints and ligaments of shoulder girdle
S43.4 Sprain of shoulder joint
S43.42 Sprain of rotator cuff capsule
S43.421 Sprain of right rotator cuff capsule
S43.421A Sprain of right rotator cuff capsule, initial encounter
If the injury is described as “Strain of right rotator cuff of shoulder”, a code from S46.01 would be reported.
S4 Injury Shoulder/Upper Arm
S46 Injury of muscle, fascia and tendon at shoulder and upper arm level
S46.0 Injury of muscle(s) and tendon(s) of the rotator cuff of shoulder
S46.01 Strain of muscle(s) and tendon(s) of the rotator cuff of shoulder
S46.011 Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder
S46.011A Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
Reminder: The 7th character indicates the phase of treatment.
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