ED Coding and Reimbursement Alert

Question: We saw a bicyclist with a ruptured Achilles tendon - which diagnosis code should we report for this condition?

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Answer: Common among cyclists as well as runners, the Achilles tendon can rupture when cyclists put too much strenuous pressure on it. For this condition, you would report a code from the following list, depending on the affected extremity:

• S86.011A (Strain of right Achilles tendon, initial encounter)
• S86.012A (Strain of left Achilles tendon, initial encounter)
• S86.019A (Strain of unspecified Achilles tendon, initial encounter)

Emergency department visits almost always represent the initial encounter for an evaluation, so what differentiates these codes from one another is that fifth character (1, 2, or 9). This character represents the foot that the doctor treats. In most cases, you'll know whether the left or right Achilles tendon was strained - it should be the rare chart that fails to include laterality.