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S86.811A
ICD-10-CM
Right Knee Strain

Find information on Right Knee Strain diagnosis, including relevant clinical documentation, medical coding (ICD-10, SNOMED CT), symptoms, treatment, and prognosis. Learn about right knee strain grading, physical exam findings, and common differential diagnoses for accurate healthcare record keeping and billing. Explore resources for knee pain, muscle strain, ligament sprain, and soft tissue injuries of the right knee. This comprehensive guide helps healthcare professionals ensure proper documentation and coding for Right Knee Strain.

Also known as

Right Knee Muscle Strain
Right Quadriceps Strain

Diagnosis Snapshot

Key Facts
  • Definition : Stretching or tearing of knee ligaments or tendons, causing pain and limited mobility.
  • Clinical Signs : Pain, swelling, stiffness, tenderness, difficulty bearing weight, popping sensation.
  • Common Settings : Sports injuries, falls, overuse, sudden twisting motions.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S86.811A Coding
S73

Sprain and strain of knee and leg

Covers sprains and strains of the knee and leg.

M25.5

Pain in knee

Specifies pain localized to the knee joint.

W00-W19

Falls

Encompasses various types of falls, a common cause of knee strains.

Y93

Activity codes

Can specify the activity causing the knee strain.

Code-Specific Guidance

Decision Tree for

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

Is there a tear of the right knee ligament?

  • Yes

    Code a right knee sprain with a specific 7th character for the current encounter and the appropriate ICD-10-CM code for the tear (e.g., S83.511A, S83.512A with a ligament tear code).

  • No

    Is the right knee strain specified as chronic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Right Knee Strain
Right Knee Sprain
Right Knee Internal Derangement

Documentation Best Practices

Documentation Checklist
  • Right knee strain ICD-10 code
  • Detailed laterality: right knee
  • Mechanism of injury documentation
  • Severity (mild, moderate, severe)
  • Objective findings on exam

Coding and Audit Risks

Common Risks
  • Unspecified Strain

    Coding with unspecified strain (S86.9) without documenting specific location or laterality increases claim denial risk and reduces reimbursement.

  • Incomplete Documentation

    Lack of documentation specifying laterality (right) or degree (mild, moderate, severe) may lead to coding errors and compliance issues.

  • MCC/CC Capture

    Missing documentation of major comorbidities/complications (MCC/CC) with right knee strain impacts accurate DRG assignment and appropriate reimbursement.

Mitigation Tips

Best Practices
  • RICE therapy (Rest, Ice, Compression, Elevation)
  • Accurate ICD-10 coding (S73.1xxA, S73.1xxD, S86.1xxA, S86.1xxD) for knee strain
  • Thorough documentation of injury mechanism, severity, and location for CDI
  • Pain management: NSAIDs, physical therapy for compliance with treatment plan
  • Follow-up care crucial for monitoring healing, adjust treatment if needed

Clinical Decision Support

Checklist
  • 1. Verify pain/tenderness localized to right knee area.
  • 2. Confirm ROM limitation/stiffness in right knee.
  • 3. R/O fracture/dislocation via imaging if indicated.
  • 4. Document mechanism of injury, severity, and symptoms.
  • 5. Evaluate for instability/effusion for accurate ICD-10 coding.

Reimbursement and Quality Metrics

Impact Summary
  • Right Knee Strain: Reimbursement and Quality Metrics Impact Summary
  • Keywords: Medical Billing, ICD-10, CPT Codes, Knee Strain, Reimbursement, Claim Denial, Quality Reporting, Physician Documentation, Hospital Revenue Cycle
  • Impact 1: Accurate ICD-10 (e.g., S13.4xxA) and CPT coding maximizes reimbursement, prevents claim denials.
  • Impact 2: Precise documentation of injury mechanism and severity impacts quality metrics for patient outcomes.
  • Impact 3: Proper coding affects hospital reporting on musculoskeletal injury prevalence and treatment effectiveness.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Code knee strain laterality
  • Specify strain severity
  • Document mechanism of injury
  • Consider 719.4x for unspecified
  • Add activity limitations detail

Documentation Templates

Patient presents with complaints of right knee pain consistent with a right knee strain. Onset of pain occurred [Date of onset] while [Mechanism of injury - e.g., running, twisting, playing sports].  Patient denies any popping or clicking sounds at the time of injury.  Pain is localized to the [Location of pain - e.g., medial aspect, lateral aspect, posterior knee] and described as [Character of pain - e.g., sharp, dull, aching].  Patient reports [Severity of pain - e.g., mild, moderate, severe] pain, aggravated by [Aggravating factors - e.g., weight-bearing, bending, straightening] and alleviated by [Alleviating factors - e.g., rest, ice, elevation].  Physical examination reveals [Objective findings - e.g., tenderness to palpation, mild swelling, full range of motion with pain at end range, negative McMurray test].  No signs of effusion or instability are noted.  Diagnosis of right knee strain is made based on clinical presentation and physical examination findings.  Differential diagnoses considered include meniscus tear, ligament sprain, and patellofemoral pain syndrome.  Treatment plan includes RICE therapy (rest, ice, compression, elevation), NSAIDs for pain management, and physical therapy for strengthening and range of motion exercises.  Patient advised to avoid strenuous activities and weight-bearing as tolerated.  Follow-up appointment scheduled in [Duration - e.g., one week, two weeks] to assess progress and adjust treatment plan as needed.  ICD-10 code S13.411A, Right knee strain.