ICD-10 Coding for Left Hamstring Strain(S76.312A, S76.312D)
Complete ICD-10-CM coding and documentation guide for Left Hamstring Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Hamstring Strain
S76.3Primary Range
Injury of muscle, fascia and tendon at thigh level
This range includes specific codes for muscle strains in the thigh, including the hamstring.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S76.312A | Strain of muscle, fascia and tendon of left thigh, initial encounter | Use for initial encounter of acute left hamstring strain with confirmed diagnosis. |
|
| S76.312D | Strain of muscle, fascia and tendon of left thigh, subsequent encounter | Use for follow-up visits after the initial treatment of a left hamstring 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 left hamstring strain
Essential facts and insights about Left Hamstring Strain
Primary ICD-10-CM Codes for left hamstring strain
Decision Criteria
clinical Criteria
- Presence of acute pain and functional impairment in the left thigh
documentation Criteria
- Detailed description of the injury mechanism and clinical examination findings
Applicable To
- Acute left hamstring strain
Clinical Validation Requirements
- Sudden onset of posterior thigh pain during activity
- MRI or ultrasound confirmation of muscle tear
- Tenderness on palpation and reduced range of motion
Code-Specific Risks
- Incorrect laterality documentation
- Missing mechanism of injury
Coding Notes
- Ensure documentation includes specific details about the mechanism of injury and clinical findings.
S76.312D - Strain of muscle, fascia and tendon of left thigh, subsequent encounter
Use for follow-up visits after the initial treatment of a left hamstring strain.
Applicable To
- Follow-up for left hamstring strain
Excludes
- Initial encounter (S76.312A)
- Sequela (S76.312S)
Clinical Validation Requirements
- Ongoing treatment for left hamstring strain
- Documentation of rehabilitation activities
Coding Notes
Ensure follow-up documentation includes details of rehabilitation and patient progress.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in left leg
M79.605Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Strain of muscle, fascia and tendon of right thigh, initial encounter
S76.311AStrain of muscle, fascia and tendon of unspecified thigh, initial encounter
S76.319AStrain of muscle, fascia and tendon of left thigh, initial encounter
S76.312ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Hamstring Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S76.312A.
Impact
Clinical: Leads to incorrect treatment planning., Regulatory: Increases audit risk due to lack of specificity., Financial: Potential for claim rejections or reduced reimbursement.
Mitigation Strategy
Always document the side of the body affected., Use EHR prompts to ensure laterality is captured.
Impact
Reimbursement: May lead to claim denials or reduced payments., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always use specific codes for left or right thigh when documentation allows.
Impact
Using the wrong 7th character for encounter type can lead to audits.
Mitigation Strategy
Implement EHR checks to ensure correct encounter type is selected.
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 Left Hamstring Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Hamstring Strain
Use these documentation templates to ensure complete and accurate documentation for Left Hamstring Strain. These templates include all required elements for proper coding and billing.
Initial evaluation of left hamstring strain
Specialty: Sports MedicineRequired Elements
- Patient history
- Mechanism of injury
- Physical examination findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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