S86.312A — Strain of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter
S86.312A is a billable, specific ICD-10-CM code for strain of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S86
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S86.312A 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.
Medicare coverage
S86.312A is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52465Knee Orthoses - Policy Article
- A52465Knee Orthoses - Policy Article
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S86.312. If S86.312A is not quite right, the correct code is usually one of these.
Questions about S86.312A
- Is S86.312A a billable ICD-10-CM code?
- Yes. S86.312A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S86.312A 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).