ICD-10 Coding for Tennis Elbow(M77.11, M77.12)
Complete ICD-10-CM coding and documentation guide for Tennis Elbow. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tennis Elbow
M77.1Primary Range
Other enthesopathy of elbow region
This range includes codes specific to lateral epicondylitis, which is the primary condition discussed.
Pain in elbow
This range includes codes for elbow pain, which may be used if the specific diagnosis of lateral epicondylitis is not confirmed.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M77.11 | Lateral epicondylitis, right elbow | Use when the patient has confirmed lateral epicondylitis on the right elbow. |
|
| M77.12 | Lateral epicondylitis, left elbow | Use when the patient has confirmed lateral epicondylitis on the left elbow. |
|
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 tennis elbow
Essential facts and insights about Tennis Elbow
Primary ICD-10-CM Codes for tennis elbow
Decision Criteria
clinical Criteria
- Presence of lateral epicondyle tenderness and pain on resisted wrist extension.
Applicable To
- Tennis elbow affecting the right side
Excludes
- Medial epicondylitis (M77.01)
Clinical Validation Requirements
- Tenderness over lateral epicondyle
- Pain on resisted wrist extension
- MRI showing tendinosis of extensor carpi radialis brevis
Code-Specific Risks
- Misclassification if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid coding errors.
M77.12 - Lateral epicondylitis, left elbow
Use when the patient has confirmed lateral epicondylitis on the left elbow.
Applicable To
- Tennis elbow affecting the left side
Excludes
- Medial epicondylitis (M77.02)
Clinical Validation Requirements
- Tenderness over lateral epicondyle
- Pain on resisted wrist extension
- MRI showing tendinosis of extensor carpi radialis brevis
Coding Notes
Ensure laterality is documented to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
X-ray of elbow, 2 views
73070Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Tennis Elbow to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M77.11.
Impact
Clinical: Leads to ambiguity in treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Always specify right or left in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of clinical data and statistics.
Mitigation Strategy
Document specific diagnosis and laterality to use M77.11 or M77.12.
Impact
Failure to document laterality can lead to audit issues.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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 Tennis Elbow, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tennis Elbow
Use these documentation templates to ensure complete and accurate documentation for Tennis Elbow. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for suspected tennis elbow
Specialty: OrthopedicsRequired Elements
- Patient history of elbow pain
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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