S86.109A (Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, initial encounter)
compared with
S86.109D (Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, subsequent encounter),
from the official CMS tabular data. S86.109A and S86.109D code the same injury at a different phase of treatment.
Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, subsequent encounter
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Can these codes be reported together?
Same injury, other encounter phase. S86.109A and S86.109D code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
Definition
Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, initial encounter is a billable ICD-10-CM diagnosis code (S86.109A).
Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, subsequent encounter is a billable ICD-10-CM diagnosis code (S86.109D).
7th character
The appropriate 7th character is to be added to each code from category S86
The appropriate 7th character is to be added to each code from category S86