S86
S86 — Injury of muscle, fascia and tendon at lower leg level
Non-billable headerICD-10-CM
S86 is a non-billable header ICD-10-CM code for injury of muscle, fascia and tendon at lower leg level. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category S86
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any associated open wound (S81.-)
Risk adjustment
S86 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead S86
6 child codes. Green means billable.
- S86.0Injury of Achilles tendon
- S86.1Injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level
- S86.2Injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level
- S86.3Injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level
- S86.8Injury of other muscles and tendons at lower leg level
- S86.9Injury of unspecified muscle and tendon at lower leg level
Questions about S86
- Is S86 a billable ICD-10-CM code?
- No. S86 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S86 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).