ICD-10 Coding for Groin Strain(S76.211A, S76.312D)
Complete ICD-10-CM coding and documentation guide for Groin Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Groin Strain
S76.2-S76.3Primary Range
Strain of muscle, fascia and tendon at thigh level
This range includes specific codes for strains of the adductor and iliopsoas muscles, which are common in groin strain diagnoses.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S76.211A | Strain of right adductor muscle, fascia and tendon, initial encounter | Use when the documentation specifies a strain of the right adductor muscle with initial treatment. |
|
| S76.312D | Strain of left iliopsoas muscle, fascia and tendon, subsequent encounter | Use for follow-up visits when the patient is receiving ongoing treatment for a left iliopsoas strain. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for groin strain
Essential facts and insights about Groin Strain
Primary ICD-10-CM Codes for groin strain
Decision Criteria
clinical Criteria
- MRI shows adductor muscle tear
documentation Criteria
- Documentation specifies right adductor muscle
Applicable To
- Right adductor longus strain
- Right adductor brevis strain
Excludes
- Sprain of hip (S73.1XXA)
Clinical Validation Requirements
- MRI confirmation of muscle fiber disruption
- Physical exam showing reduced strength and tenderness
Code-Specific Risks
- Risk of using unspecified codes when laterality is documented
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
S76.312D - Strain of left iliopsoas muscle, fascia and tendon, subsequent encounter
Use for follow-up visits when the patient is receiving ongoing treatment for a left iliopsoas strain.
Applicable To
- Left iliopsoas strain
Excludes
- Sprain of hip (S73.1XXA)
Clinical Validation Requirements
- Ultrasound showing scar tissue
- Recurrent pain documented
Coding Notes
Ensure encounter type is correctly documented to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Sprain of hip
S73.1XXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Groin Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S76.211A.
Impact
Clinical: Impacts treatment planning, Regulatory: Non-compliance with coding guidelines, Financial: Potential for reduced reimbursement
Mitigation Strategy
Always include laterality in documentation, Use templates that prompt for laterality
Impact
Reimbursement: May lead to lower reimbursement rates, Compliance: Increases risk of audits and denials, Data Quality: Reduces accuracy of clinical data
Mitigation Strategy
Always document and code the specific muscle and laterality involved.
Impact
Using unspecified codes when specific codes are available
Mitigation Strategy
Ensure thorough documentation and use of specific codes
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Groin Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Groin Strain
Use these documentation templates to ensure complete and accurate documentation for Groin Strain. These templates include all required elements for proper coding and billing.
Acute right adductor strain during sports
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Specific muscle involved
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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