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S76.199A
ICD-10-CM
Patellar Tendon Rupture

Find information on Patellar Tendon Rupture diagnosis including clinical documentation, medical coding, ICD-10 codes S86.001A, S86.001D, S86.001S, S86.002A, S86.002D, S86.002S, and CPT codes for surgical repair and non-surgical treatment. Learn about symptoms, diagnostic criteria, and treatment options for complete and partial patellar tendon tears. This resource provides valuable insights for healthcare professionals, coders, and billers seeking accurate and comprehensive information on Patellar Tendon Rupture.

Also known as

Kneecap Tendon Rupture
Patellar Ligament Tear

Diagnosis Snapshot

Key Facts
  • Definition : Tear of the tendon connecting the kneecap (patella) to the shinbone (tibia).
  • Clinical Signs : Sudden pain below kneecap, inability to straighten knee, palpable gap, bruising.
  • Common Settings : Sports injury, falls, overuse, steroid use, chronic conditions.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S76.199A Coding
S86.0

Sprain and strain of knee and leg

Includes patellar tendon rupture.

S76

Injury of lower leg

Includes injuries to soft tissues like tendons.

S80-S89

Injuries to the knee and lower leg

Encompasses a wide range of leg injuries.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the patellar tendon rupture traumatic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Patellar Tendon Rupture
Patellar Tendinitis
Quadriceps Tendon Rupture

Documentation Best Practices

Documentation Checklist
  • Patellar tendon rupture ICD-10 diagnosis code
  • Document mechanism of injury (MOI)
  • Physical exam: Palpable defect, lack of extension
  • Imaging confirmation: Ultrasound or MRI findings
  • Surgical plan if applicable: Repair vs. reconstruction

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Missing or incorrect laterality (right, left, bilateral) for patellar tendon rupture can lead to claim denials and inaccurate data.

  • Traumatic vs. Atraumatic

    Failing to distinguish between traumatic (S86.0-) and atraumatic (M23.0-) rupture impacts coding accuracy and reimbursement.

  • Specificity of Diagnosis

    Coding a general knee injury (e.g., S89.-) instead of the specific patellar tendon rupture code lacks detail and affects quality metrics.

Mitigation Tips

Best Practices
  • Thorough physical exam: palpate, assess ROM, test extension strength.
  • Image with MRI or ultrasound for definitive rupture confirmation. ICD-10: S86.00
  • Document mechanism of injury, symptoms onset, prior treatments. CDI best practice.
  • Consult orthopedics promptly. Timely referral improves outcomes. CPT: 99241-99245
  • Accurate coding: distinguish partial vs complete tear. Ensure healthcare compliance.

Clinical Decision Support

Checklist
  • 1. Palpable tendon defect? Document gap location/size.
  • 2. Inability to extend knee? Assess passive ROM.
  • 3. Patella alta on imaging? Compare to contralateral side.
  • 4. Positive Thompson test? Document examiner technique.

Reimbursement and Quality Metrics

Impact Summary
  • Patellar Tendon Rupture: Coding accuracy impacts reimbursement for surgical repair (CPT 27566, 27380, 27405) and affects hospital quality reporting metrics related to surgical site infection (SSI) and readmission rates. Accurate ICD-10-CM coding (S86.001A, S86.009A) is crucial for appropriate reimbursement and quality data analysis.
  • Impacts:
  • Accurate coding = Higher reimbursement
  • Coding errors = Claim denials, lower payments
  • SSI tracking affects quality scores
  • Readmission rates influence hospital value-based payments

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • ICD-10 S76.0 patellar tendon rupture
  • Document mechanism, laterality
  • MRI confirms diagnosis, code extent
  • Surgical repair: add procedure code
  • Post-op complications, code separately

Documentation Templates

Patient presents with complaints consistent with patellar tendon rupture.  Onset of injury occurred on [Date of injury] during [Mechanism of injury - e.g., athletic activity, fall].  Patient reports a sudden popping sensation in the knee followed by immediate pain and inability to bear weight.  Physical examination reveals [Specify location] tenderness, palpable defect superior to the patella, and an inability to actively extend the knee.  Passive knee flexion is present but painful.  Patellar apprehension is positive.  A positive Thompson test suggests a complete rupture.  Differential diagnosis includes patellar tendinopathy, quadriceps tendon rupture, and knee effusion.  Imaging studies including knee x-ray and potentially MRI are ordered to confirm the diagnosis and evaluate the extent of the tear.  Preliminary diagnosis of patellar tendon rupture is made based on clinical findings.  Treatment plan includes consultation with orthopedic surgery, potential surgical repair of the tendon, pain management with NSAIDs and or other analgesics as indicated, immobilization with a knee brace or splint, and physical therapy following surgical intervention.  ICD-10 code M26.57 and CPT codes 27540-27548 (depending on the surgical approach and complexity) are anticipated.  Patient education provided regarding post-operative care, rehabilitation, and expected recovery time.  Follow-up appointment scheduled with orthopedic surgery in [Number] days.  Risks and benefits of surgical and non-surgical treatment options were discussed, and the patient demonstrates understanding.  The patient's prognosis for regaining full function is [Prognosis - e.g., good, fair, guarded] pending surgical intervention and adherence to post-operative rehabilitation.
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