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Home/Diagnosis/ICD-10 Coding for Biceps Tear

ICD-10 Coding for Biceps Tear

S46.11XA
M66.88

Complete ICD-10-CM coding and documentation guide for icd-10 coding for biceps tear includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Biceps Tendon Rupture
Long Head of Biceps Tear
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Key Information: ICD-10 Coding for Biceps Tear

Essential facts and insights about ICD-10 Coding for Biceps Tear

Use ICD-10 code S46.11XA for injury of muscle and tendon of long head of biceps, right arm, initial encounter, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Injury of muscle and tendon of long head of biceps, right arm, initial encounter

Non-Billable
S46.11XA
Non-Billable

Diagnostic Criteria

clinical:
  • • Presence of acute trauma and MRI confirmation
documentation:
  • • Detailed mechanism of injury and clinical findings

Applicable To

  • • Acute traumatic tear of right biceps tendon

Important Notes

  • • Ensure laterality is specified and confirm acute vs. chronic nature.

Spontaneous rupture of other tendons, other site

Billable Code
M66.88
Billable

Diagnostic Criteria

clinical:
  • • MRI showing degenerative changes
  • • Absence of acute trauma history

Applicable To

  • • Non-traumatic degenerative tear of biceps tendon

Important Notes

  • • Document chronicity and absence of trauma clearly.
Ancillary Codes

Additional codes that may be used with this diagnosis

S43.42XA

Superior glenoid labrum lesion, initial encounter

Use when a concurrent SLAP lesion is identified.

Frequently Asked Questions

What is the ICD-10 code for a biceps tear?

The ICD-10 code for a traumatic biceps tear is S46.1, with specific codes for laterality. Non-traumatic tears are coded under M66.8.

How do you code a non-traumatic biceps tear?

Non-traumatic biceps tears, often degenerative, are coded as M66.8, indicating a spontaneous rupture without acute injury.

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