Valid for Submission
S76.319A is a billable diagnosis code used to specify a medical diagnosis of strain of muscle, fascia and tendon of the posterior muscle group at thigh level, unspecified thigh, initial encounter. The code S76.319A is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S76.319A might also be used to specify conditions or terms like hamstring injury, rupture of hamstring tendon, strain of hamstring muscle or strain of hamstring tendon.
S76.319A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like strain of muscle fascia and tendon of the posterior muscle group at thigh level unspecified thigh. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
Unspecified diagnosis codes like S76.319A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The appropriate 7th character is to be added to each code from block Injury of muscle, fascia and tendon at hip and thigh level (S76). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Hamstring injury
- Rupture of hamstring tendon
- Strain of hamstring muscle
- Strain of hamstring tendon
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|537||SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC||08||0.9332|
|538||SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC||08||0.7214|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert S76.319A to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S76.319A its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Information for Patients
Leg Injuries and Disorders
Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures (broken bones).
These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg problems. For example, knee osteoarthritis, common in older people, can cause pain and limited motion. Problems in your veins in your legs can lead to varicose veins or deep vein thrombosis.
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Sprains and Strains
A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.
A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.
At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
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