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ICD-10 Coding for Wrestling-Related Injuries(S43.421A, S86.212A)

Complete ICD-10-CM coding and documentation guide for Wrestling-Related Injuries. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Wrestling InjuriesInjuries from Wrestling

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Related ICD-10 Code Ranges

Complete code families applicable to Wrestling-Related Injuries

S00-T88Primary Range

Injury, poisoning and certain other consequences of external causes

This range includes all types of injuries that can occur during wrestling, such as sprains, strains, and fractures.

Y93.72

Activity, wrestling

This code is used to specify that the injury occurred during wrestling.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
S43.421ASprain of right acromioclavicular joint, initial encounterUse when the patient has a confirmed sprain of the right acromioclavicular joint from a wrestling activity.
  • Positive apprehension test
  • Cross-body adduction pain
S86.212AStrain of muscle and tendon of the Achilles, right leg, initial encounterUse when the patient has a confirmed strain of the Achilles tendon from wrestling.
  • Plantar flexion against resistance
  • Tenderness over Achilles tendon

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 wrestling injuries

Essential facts and insights about Wrestling-Related Injuries

The ICD-10 code for wrestling-related injuries includes the specific injury code, such as S43.421A for a right shoulder sprain, with Y93.72 to indicate wrestling as the activity.

Primary ICD-10-CM Codes for wrestling

S43.421A
Sprain of right acromioclavicular joint, initial encounter
Billable Code

Decision Criteria

clinical Criteria

  • Confirmed sprain of the right acromioclavicular joint with wrestling as the activity.

Applicable To

  • Right shoulder sprain during wrestling

Excludes

  • Fracture of shoulder

Clinical Validation Requirements

  • Positive apprehension test
  • Cross-body adduction pain

Code-Specific Risks

  • Incorrect laterality documentation
  • Missing activity code

Coding Notes

  • Ensure laterality is documented and the activity code is included.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Activity, wrestling

Y93.72
Use to indicate the injury occurred during wrestling.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic

M75.11
Use if imaging confirms tendon tear rather than a sprain.

Strain of muscle(s) and tendon(s) of the posterior muscle group at lower leg level, right leg, initial encounter

S86.011A
Use if the strain involves other posterior muscles rather than the Achilles.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Wrestling-Related Injuries to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.421A.

Impact

Clinical: Inaccurate representation of the injury context., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.

Mitigation Strategy

Use checklists to ensure all relevant codes are included., Educate staff on the importance of activity codes.

Impact

Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases the accuracy of healthcare data.

Mitigation Strategy

Always use specific codes that include laterality, such as S43.421A for right shoulder sprain.

Impact

Failure to document all necessary details for wrestling injuries.

Mitigation Strategy

Use comprehensive templates and checklists.

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 Wrestling-Related Injuries, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Wrestling-Related Injuries

Use these documentation templates to ensure complete and accurate documentation for Wrestling-Related Injuries. These templates include all required elements for proper coding and billing.

Wrestling Injury Documentation

Specialty: Sports Medicine

Required Elements

  • Mechanism of injury
  • Laterality
  • Specific wrestling activity
  • Objective findings

Example Documentation

18yo male sustained direct impact to right ear during Greco-Roman wrestling match, resulting in auricular hematoma (S00.431A). No tympanic membrane rupture on otoscopy. Activity code Y93.72 applied. Treated with incision/drainage.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Shoulder hurt during wrestling.
Good Documentation Example
Grade II AC joint sprain of right shoulder sustained during takedown maneuver in wrestling match on [date].
Explanation
The good example includes specific details about the injury, laterality, and activity, which are necessary for accurate coding.

Need help with ICD-10 coding for Wrestling-Related Injuries? Ask your questions below.

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