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ICD-10 Coding for Hamstring Tear(S76.311A, M66.85, M66.851)

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Learn about ICD-10 coding for hamstring tears, including primary codes, documentation requirements, and common pitfalls.

Also known as:
Hamstring StrainPosterior Thigh Muscle Tear
Related ICD-10 Code Ranges

Complete code families applicable to Hamstring 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
S76.311AStrain of muscle, fascia and tendon of the posterior muscle group at thigh level, right thigh, initial encounter
S76.312AStrain of muscle, fascia and tendon of the posterior muscle group at thigh level, left thigh, initial encounter
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

Spontaneous rupture of other tendons, right thighM66.851

Use when there is no trauma involved and the rupture is spontaneous.

Spontaneous rupture of other tendons, left thighM66.852

Use when there is no trauma involved and the rupture is spontaneous.

Documentation & Coding Risks

Avoid these common issues when documenting Hamstring Tear.

Omitting external cause codes

Impact

Clinical: Incomplete clinical picture of the injury., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.

Mitigation

Always include external cause codes when applicable., Review clinical documentation for activity details.

Confusing laterality in coding

Impact

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

Mitigation

Verify the side of the injury from the clinical documentation before coding.

Incorrect encounter coding

Impact

Using initial encounter codes for follow-up visits.

Mitigation

Verify encounter type from clinical notes before coding.

Frequently Asked Questions

Related condition guides

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