ICD-10 Coding for Tendinitis(M76.6, M65.3)
Complete ICD-10-CM coding and documentation guide for Tendinitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tendinitis
M65-M77Primary Range
Disorders of synovium and tendon
This range includes codes for various tendinitis conditions affecting different tendons and regions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M76.6 | Achilles tendinitis | Use when clinical findings confirm Achilles tendon inflammation without rupture. |
|
| M65.3 | Rotator cuff tendinitis | Use when clinical examination confirms rotator cuff inflammation. |
|
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 Achilles tendinitis
Essential facts and insights about Tendinitis
Primary ICD-10-CM Codes for tendinitis
Decision Criteria
clinical Criteria
- Presence of localized pain and positive arc sign
coding Criteria
- Specify laterality and confirm absence of rupture
Applicable To
- Achilles tendinitis
Excludes
- Achilles bursitis (M76.61)
Clinical Validation Requirements
- Pain localized 2-6cm above calcaneal insertion
- Positive arc sign
- Inability to perform single-leg heel raise
Code-Specific Risks
- Confusing with Achilles bursitis
- Using unspecified codes
Coding Notes
- Ensure laterality is specified to avoid unspecified coding.
M65.3 - Rotator cuff tendinitis
Use when clinical examination confirms rotator cuff inflammation.
Applicable To
- Rotator cuff tendinitis
Excludes
- Calcific tendinitis of shoulder (M75.3)
Clinical Validation Requirements
- Painful arc (70-120° abduction)
- Weakness in Hawkins-Kennedy test
- Tenderness over greater tuberosity
Coding Notes
Document specific tests and imaging findings to support diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Tendinitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M76.6.
Impact
Clinical: May lead to incorrect treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always specify the tendon in clinical notes., Use detailed physical exam findings.
Impact
Reimbursement: May lead to claim denials or reduced payment., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always specify the affected tendon and laterality.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation includes specific details to support precise coding.
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 Tendinitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tendinitis
Use these documentation templates to ensure complete and accurate documentation for Tendinitis. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of shoulder pain
Specialty: OrthopedicsRequired Elements
- Subjective: Patient's description of pain
- Objective: Physical exam findings
- Assessment: Diagnosis with laterality
- Plan: Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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