ICD-10 Codes for Reporting Five Common Spring Sports Injuries

by | Published on Mar 25, 2021 | Resources, Articles, Medical Billing (A) | 0 comments

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During the spring season, people are gearing up for a new series of sports. Whether their goal is to stay active or train or participate in a competitive sport, spring is the perfect time to get back in the swing of things. During the spring season, as temperatures begin to warm up, there is a possibility of injuries from various activities. In fact, physician’s offices, ERs and hospitals fill up with patients suffering from a variety of spring related sports injuries. Physicians need to be ready with the ICD-10 codes for these common seasonal conditions and outsourced medical billing services from a reliable and experienced provider can ensure this.

There are different types of spring injuries that occur due to lack of conditioning of the muscles and joints. Overuse, repetitive activities and the unnatural strain certain motions place on various joints in the body are the top causes for spring sport injuries. In addition, injuries can also occur due to lack of conditioning of the muscles and joints. If not treated properly, these injuries can cause lingering problems. Weakening of the joints is one of the common symptoms associated with these injuries. When joint weakening occurs, people just become prone to more serious injuries beyond just soreness. The weakened joints, tendons and muscle structure, are more susceptible to strains and sprains. This is one key reason why adequate rest between sports activities and even training sessions is critical.

Let’s take a look at some common spring sports injuries and their ICD-10 codes –

Little League Elbow – Little league elbow (also known as an apophysitis) is a growth plate injury to the medial (inner) part of the elbow that occurs due to repetitive throwing motions. A common problem among young, adolescent baseball players, the condition is a growth plate injury to the medial (inner) part of the elbow that occurs due to repetitive throwing motions. It is estimated that the condition most commonly occurs in up to 40% of throwers. Gradual increase of medial elbow pain and stiffness (particularly while throwing) is one of the initial symptoms of the condition. If left untreated, the condition can cause severe tears in the ligaments and tendons. Treatment options for this condition depend on the extent of the growth plate injury and include – resting the affected area, applying ice packs (to reduce swelling) and using non-steroidal anti-inflammatory drugs (NSAIDS). Related ICD-10 codes include –

  • M24.82 – Other specific joint derangements of elbow, not elsewhere classified
  • M24.821 – Other specific joint derangements of right elbow, not elsewhere classified
  • M24.822 – Other specific joint derangements of left elbow, not elsewhere classified
  • M24.829 – Other specific joint derangements of unspecified elbow, not elsewhere classified

Sprains and Strains – A sprain occurs when a partial tear or direct or indirect trauma knocks out a joint from its actual position and overstretches it. If your sprain is severe and ruptures the supporting ligaments, then surgical repair may be necessary. Strain on the other hand, refers to an injury to a muscle and/or tendon caused due to overuse, force, or stretching. Athletes are more vulnerable to these injuries which occur in the foot, leg (typically the hamstring) or back. General symptoms of a strain include pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping. Common ICD-10 codes include –

  • S73.1 – Sprain of hip
  • S53.4 – Sprain of elbow
  • S93.4 – Sprain of ankle
  • S93.6 – Sprain of foot
  • S76.01 – Strain of muscle, fascia and tendon of hip
  • S76.11 – Strain of quadriceps muscle, fascia and tendon
  • S76.21 – Strain of adductor muscle, fascia and tendon of thigh
  • S76.81 – Strain of other specified muscles, fascia and tendons at thigh level

Tennis Elbow – Also called lateral epicondylitis, tennis elbow is a condition that causes severe pain and inflammation around the outside of the elbow. It 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 motion of the wrist and arm. Repetitive motion 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. Being more common among tennis players doesn’t mean that the condition does not affect non-tennis players. Other sports activities or even jobs which involve repetitive motion in the wrist and arm may lead to this condition. The condition gets its name due to the specific muscles involved and 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. ICD-10 codes include –

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

Stress Fractures – Stress fractures are caused by repetitive force, often from overuse like repeatedly jumping up and down or running long distances. It can also occur from normal use of a bone that gets weakened by a condition such as osteoporosis. The condition is more common in the weight-bearing bones of the lower leg and foot. Stress fractures often result from increasing the amount or intensity of an activity too quickly. During initial stages, patients may not experience any specific symptoms, but it tends to worsen with time. The tenderness usually starts at a specific spot and reduces in intensity as a person takes rest. In addition, patients may also experience tenderness around the painful area. Treatment involves wearing a walking boot or brace or using crutches. Surgery may be considered as an option in severe stress fracture cases where complete healing is essential. ICD-10 codes related to this condition include –

  • M84.3 Stress fracture
  • M84.30 Stress fracture, unspecified site
  • M84.31 Stress fracture, shoulder
  • M84.32 Stress fracture, humerus
  • M84.33 Stress fracture, ulna and radius
  • M84.34 Stress fracture, hand and fingers
  • M84.35 Stress fracture, pelvis and femur
  • M84.36 Stress fracture, tibia and fibula
  • M84.37 Stress fracture, ankle, foot and toes
  • M84.38 Stress fracture, other site

Achilles Tendinitis – Achilles Tendinitis is an overuse injury of the Achilles tendon (the band of tissue that connects the calf muscles at the back of the lower leg to your heel bone). This tendon is used when a person walks, runs, jumps or pushes up on his/her toes. The structure of this tendon weakens with age, making it more susceptible to injury. The condition is more common among middle-aged people who play sports like tennis or basketball (only on the weekends) or who have suddenly increased the intensity of their running programs. Symptoms may begin as a mild ache in the back of the leg or above the heel (after running or any other sports activity). Episodes of more severe pain may occur after prolonged running, stair climbing or sprinting. People may also experience tenderness or stiffness, especially in the morning. Treatment modalities involve a combination of self-care strategies like rest, icing the area, and stretching the calf muscles. The ICD-10 codes for Achilles Tendinitis (AT) –

  • M76.6 – Achilles tendinitis
  • M76.60 – Achilles tendinitis, unspecified leg
  • M76.61 – Achilles tendinitis, right leg
  • M76.62 – Achilles tendinitis, left leg

The above-mentioned are some of the common injuries occurring among people involved in spring sports. A good training regimen is the first phase towards helping to prevent and reduce the risk of these types of injuries. Playing a sport ill-prepared or suddenly increasing the duration, intensity or frequency of an activity can increase the risk of these injuries. It is always better to increase the length and intensity of these activities gradually. Wearing the appropriate sports gear is crucial when playing sports. In addition, appropriate warm-up exercises and proper stretching should also be done before engaging in any spring sport activity.

Billing and coding for spring sports injuries can be complex, as there are different types of injuries involving different codes. To ensure accurate documentation, coding and maximum reimbursement, orthopedists can outsource medical billing tasks to expert medical billers and coders.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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