2021 ICD-10-CM Code S93.516S
Sprain of interphalangeal joint of unspecified lesser toe(s), sequela
Valid for Submission
S93.516S is a billable diagnosis code used to specify a medical diagnosis of sprain of interphalangeal joint of unspecified lesser toe(s), sequela. The code S93.516S is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S93.516S might also be used to specify conditions or terms like sprain of foot, sprain of interphalangeal joint of lesser toe or sprain of interphalangeal joint of toe. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S93.516S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like sprain of interphalangeal joint of unspecified lesser toe(s). According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
Unspecified diagnosis codes like S93.516S 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.
ICD-10: | S93.516S |
Short Description: | Sprain of interphaln joint of unsp lesser toe(s), sequela |
Long Description: | Sprain of interphalangeal joint of unspecified lesser toe(s), sequela |
Code Classification
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Sprain of foot
- Sprain of interphalangeal joint of lesser toe
- Sprain of interphalangeal joint of toe
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code S93.516S is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.
Present on Admission (POA)
S93.516S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .
CMS POA Indicator Options and Definitions
POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert S93.516S to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S93.516S 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.
- 905.7 - Late effec sprain/strain (Approximate Flag)
Information for Patients
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
- Ankle sprain - aftercare (Medical Encyclopedia)
- Elbow sprain -- aftercare (Medical Encyclopedia)
- Foot sprain - aftercare (Medical Encyclopedia)
- Hamstring strain - aftercare (Medical Encyclopedia)
- Hip flexor strain -- aftercare (Medical Encyclopedia)
- Sprains (Medical Encyclopedia)
- Strains (Medical Encyclopedia)
- Tendon repair (Medical Encyclopedia)
- Wrist sprain - aftercare (Medical Encyclopedia)
[Learn More in MedlinePlus]
Toe Injuries and Disorders
Fourteen of the 26 bones in your feet are in your toes. The toes, particularly your big toe, help you move and keep your balance. Playing sports, running, stubbing your toe, and dropping something on your foot can damage your toes. Wearing shoes that are too loose or too tight can also cause toe problems. Certain diseases, such as severe arthritis, can cause toe problems and pain. Gout often causes pain in the big toe.
Common toe problems include
- Corns and bunions
- Ingrown toenails
- Sprains and dislocations
- Fractures
Treatments for toe injuries and disorders vary. They might include shoe inserts or special shoes, padding, taping, medicines, rest, and in severe cases, surgery.
- Broken toe - self care (Medical Encyclopedia)
- Bunion removal (Medical Encyclopedia)
- Bunions (Medical Encyclopedia)
- Clubbing of the fingers or toes (Medical Encyclopedia)
- Hammer toe (Medical Encyclopedia)
- Hammer toe repair (Medical Encyclopedia)
- Hammer toe repair - discharge (Medical Encyclopedia)
- Polydactyly (Medical Encyclopedia)
[Learn More in MedlinePlus]
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)