Home Health ICD-9/ICD-10 Alert

Question: Our physical therapists are frustrated that there aren't separate codes for sprain and strain. Could you share your thoughts?


Texas Subscriber


Answer: A sprain is a stretch and/or tear of a ligament (a band of fibrous tissue that connects two or more bones at a joint). One or more ligaments can be injured at the same time. The severity of the injury will depend on the extent of injury (whether a tear is partial or complete) and the number of ligaments involved.


A strain is an injury to either a muscle or a tendon (fibrous cords of tissue that connect muscle to bone). Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result from a partial or complete tear.

Code sprains and strains with the same codes depending on the location of the sprain or strain. For example, you would list the same code from the 845.0x (Sprains and strains of ankle) subcategory whether you were reporting a strained or sprained ankle. Every year in March, the ICD-9-CM Coordination and Maintenance Committee accepts proposals from interested parties who would like to see changes or additions to the codes. Your therapists should prepare a rationale for changes to the codes and present the proposal to the committee.

Unless otherwise indicated, reader questions were answered by Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX.