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ICD-10 Coding for Biceps Tendon Tear(S46.211A, M66.8, M66.821)

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Learn about ICD-10 coding for bicep tears, including traumatic and degenerative types. Find documentation tips and common coding pitfalls.

Also known as:
Bicep TearBiceps Rupture
Related ICD-10 Code Ranges

Complete code families applicable to Biceps Tendon Tear

S00-T88Primary Range

Injury, poisoning and certain other consequences of external causes

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescription
S46.211AStrain of muscle, fascia and tendon of other parts of biceps, right arm, initial encounter
M66.821Spontaneous rupture of other tendons, right arm
Primary ICD-10-CM Codes
Strain of muscle, fascia and tendon of other parts of biceps, right arm, initial encounter
S46.211ABillable
Differential Codes

Alternative codes to consider when ruling out similar conditions

Spontaneous rupture of other tendons, right armM66.821

Use for non-traumatic, degenerative ruptures.

Strain of muscle, fascia and tendon of other parts of biceps, right arm, initial encounterS46.211A

Use for traumatic strains.

Documentation & Coding Risks

Avoid these common issues when documenting Biceps Tendon Tear.

Omitting laterality in documentation

Impact

Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.

Mitigation

Use templates that prompt for laterality., Educate staff on the importance of complete documentation.

Mixing laterality in documentation

Impact

Reimbursement: Incorrect laterality can lead to denied claims., Compliance: Non-compliance with ICD-10 coding rules., Data Quality: Inaccurate patient records.

Mitigation

Always specify right or left arm in documentation.

Using traumatic codes for degenerative tears

Impact

Reimbursement: Incorrect coding may affect reimbursement rates., Compliance: Violates coding guidelines., Data Quality: Misleading clinical data.

Mitigation

Differentiate between traumatic and degenerative tears based on clinical history.

Incorrect laterality coding

Impact

Failure to specify laterality can lead to audit flags.

Mitigation

Implement mandatory fields for laterality in EHR systems.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with S46.211A.