What is the ICD-10 code for gluteus medius strain?

The ICD-10 code for a gluteus medius strain is S76.311A for the right hip and S76.312A for the left hip, used for initial encounters.

How do you document a gluteus medius strain?

Document the laterality, mechanism of injury, physical exam findings, and imaging results to ensure accurate coding and billing.

ICD-10 Coding for Gluteus Medius Strain(S76.311A, M70.61, M70.62)

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Learn about the ICD-10 coding for gluteus medius strain, including documentation requirements and common coding pitfalls.

Also known as:

Hip Abductor StrainGluteal Muscle Strain

Related ICD-10 Code Ranges

Complete code families applicable to Gluteus Medius Strain

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

Code	Description	When to Use	Key Documentation
S76.311A	Strain of muscle, fascia and tendon of right hip, initial encounter	Use for initial encounter of right gluteus medius strain with documented traumatic mechanism.	Tenderness over right greater trochanter Positive Trendelenburg sign MRI shows edema without tear
S76.312A	Strain of muscle, fascia and tendon of left hip, initial encounter	Use for initial encounter of left gluteus medius strain with documented traumatic mechanism.	Tenderness over left greater trochanter Positive Trendelenburg sign MRI shows edema without tear

Primary ICD-10-CM Codes

Strain of muscle, fascia and tendon of the posterior muscle group at thigh level, right thigh, initial encounter

S76.311ABillable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Tear of muscle, fascia and tendon of right hip, initial encounterS76.321A

Use for confirmed tears, not strains.

Tear of muscle, fascia and tendon of left hip, initial encounterS76.322A

Use for confirmed tears, not strains.

Documentation & Coding Risks

Avoid these common issues when documenting Gluteus Medius Strain.

Omitting laterality

Impact

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

Mitigation

Always document laterality in clinical notes.

Confusing strain with tear codes

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data recording.

Mitigation

Verify clinical documentation for presence of tear vs. strain.

Laterality documentation

Impact

Failure to document laterality can lead to audit issues.

Mitigation

Implement checklist for documentation completeness.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with S76.311A.

Primary Code

S76.311A

Strain of muscle, fascia and tendon of the posterior muscle group at thigh level, right thigh, initial encounter

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ICD-10 codes8

Coding risks3

FAQs2

ICD-10 Coding for Gluteus Medius Strain(S76.311A, M70.61, M70.62)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for gluteus medius strain?

How do you document a gluteus medius strain?

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