Regarded as one of the most common sports related elbow injuries, tennis elbow is a condition that causes pain and inflammation around the outside of the elbow. Also called lateral epicondylitis, the condition occurs when the tendons (that join the muscles of the forearm to the outside of the elbow) in the elbow are overloaded, usually by repetitive motions of the wrist and arm. The repeated movements may result in a series of tiny tears in the tendons that attach the forearm muscles to the bony prominence at the outside of the elbow. This painful condition can affect people of any age group but is most common among people in the age group of 30 – 50 years. For majority of patients, tennis elbow is treated non-surgically to relieve pain and weakness associated with the condition. Using the right medical codes for documenting the symptoms, diagnosis and treatment of this sports injury is crucial for accurate processing of medical claims. Outsourcing medical billing and coding tasks to a reliable medical billing company can help physicians submit their medical claims without errors.

Reports suggest that tennis elbow affects between 1 to 3 percent of the population in the United States. As the name suggests, playing tennis sport is one of the prominent causes of this condition. However, many other common arm motions such as using plumbing tools, driving screws, repetitive use of computer mouse, playing some types of musical instruments and painting can cause tennis elbow.

Understand the Symptoms

A burning sensation and pain surrounding the elbow is one of the common symptoms associated with the condition. Other related signs and symptoms include wrist weakness, chronic pain when lifting or bending the arm, difficulty in extending the forearm fully, pain and stiffness when fully extending the arm, pain when lifting and carrying, and tenderness outside the elbow. The pain and discomfort may radiate from the outside of the joint into the forearm and wrist and can last for weeks, months and years. If left untreated, the pain can get worse so that it can become extremely difficult for patients to even shake hands or grip an object, turn a doorknob or even hold a cup of coffee.

Tennis elbow being more common among tennis players doesn’t mean that the condition does not affect non-tennis players. Even non-tennis players can experience this painful elbow condition. The condition gets its name due to the specific muscles involved. The wrist extensors are at work during the common tennis motions of cocking the wrist back and stabilizing it while gripping a racquet. Other sports activities or even jobs which involve repetitive motions in the wrist and arm may lead to this condition.

Diagnosing and Treating Tennis Elbow

Diagnosis of lateral epicondylitis may begin with a detailed physical examination and medical history review. Pain management physicians may apply pressure to the affected area or ask patients to move their elbow, wrist and fingers in various ways to identify the root cause of pain. If the physician suspects that some other factors are causing the symptoms, X-rays or other types of imaging tests may be recommended to confirm the diagnosis.

For majority of patients, tennis elbow is treated non-surgically as it helps relieve pain and weakness associated with the condition. Treatment methods for this condition may vary depending on the type and severity of symptoms. Top treatment modalities include – physical therapy, Transcutaneous Electrical Nerve Stimulation (TENS), chiropractic care, pain injections, Non-steroidal anti-inflammatory drugs (NSAIDs), cold therapy and compression and extracorporeal shock wave therapy. However, if the pain in the elbow becomes severe and chronic, surgery to remove the damaged part of the tendons would be recommended by physicians.

Orthopedic medical billing and coding is a complex procedure. The symptoms, diagnosis and treatment procedures offered by orthopedists and other pain management specialists must be documented using the correct medical codes. Billing and coding services offered by a reliable medical billing and coding company can help physicians use the correct medical codes for their billing purposes. The following ICD-10 and CPT codes are used for billing procedures –

ICD-10 Codes

  • M77.1 – Lateral epicondylitis
  • M77.10 – Lateral epicondylitis, unspecified elbow
  • M77.11 – Lateral epicondylitis, right elbow
  • M77.12 – Lateral epicondylitis, left elbow

CPT Codes

  • 24357 – Tenotomy, elbow, lateral or medial (e.g. epicondylitis, tennis elbow, golfer’s elbow); percutaneous
  • 24358 – Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer’s elbow); debridement, soft tissue and/or bone, open
  • 24359 – Tenotomy, elbow, lateral or medial (e.g. epicondylitis, tennis elbow, golfer’s elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment
  • 0101T – Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, high energy
  • 0102T – Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, involving lateral humeral epicondyle
  • 28890 – Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia

HCPCS Codes

  • L3702 – Elbow orthosis (EO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
  • L3710 – Elbow orthosis (EO), elastic with metal joints, prefabricated, off-the-shelf
  • L3720 – Elbow orthosis (EO), double upright with forearm/arm cuffs, free motion, custom-fabricated
  • L3730 – Elbow orthosis (EO), double upright with forearm/arm cuffs, extension/ flexion assist, custom-fabricated
  • L3740 – Elbow orthosis (EO), double upright with forearm/arm cuffs, adjustable position lock with active control, custom-fabricated
  • L3760 – Elbow orthosis (EO), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
  • L3761 – Elbow orthosis (EO), with adjustable position locking joint(s), prefabricated, off-the-shelf
  • L3762 – Elbow orthosis (EO), rigid, without joints, includes soft interface material, prefabricated, off-the-shelf

Taking proper rest is one of the important steps for managing the symptoms of tennis elbow. It is important to avoid or modify physical activities that cause strain to the affected muscles and tendons. Patients, in most cases are advised to stop participating in sports activities or other manual tasks (that involve lifting) for several weeks until the damaged tendons heal and the pain in the arm subsides completely. In some cases, to prevent further damage to the tendons, patients can wear an arm brace or a wrist splint when using the arm. A physiotherapist can recommend the type of brace or splint to use.

Medical billing and coding for sports injuries can be complex, as there are different codes associated with the condition. By outsourcing these tasks to a reliable medical billing service provider that offers the services of AAPC-certified coding specialists, healthcare practices can ensure correct and timely medical billing and claims submission.