S160-S169
Medium Complexity

Injuries to the knee and lower leg

Primary Specialty: Orthopedic Surgery
Last Updated: 2025-09-10

ICD-10 Codes (0)

0 billable
0 category headers

No codes found matching your search

Updates & Changes

FY 2026 Updates

Current Year

New Codes (1)

S06.2X9A
Diffuse traumatic brain injury with loss of consciousness of unspecified duration, initial encounter

Revised Codes (1)

S06.0X0A
Concussion without loss of consciousness - updated post-concussion syndrome correlation

Deleted Codes

No codes deleted in this range for FY 2026

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for S160-S169 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The ICD-10 code range S160-S169 pertains to injuries to the knee and lower leg. These codes are used to document various types of injuries, including fractures, dislocations, sprains, strains, contusions, crushing injuries, open wounds, and complications of injuries. The codes provide detailed information about the location and nature of the injury, making them essential for accurate medical documentation and billing.

Key Usage Points:

  • Always use a more specific code if available.
  • Use additional code to identify any associated open wound.
  • Use additional code to identify any retained foreign body.
  • For aftercare of injury, use a follow-up code.
  • For complications of injuries, use the appropriate complication code.

Coding Guidelines

When to Use:

  • When documenting a new injury to the knee or lower leg.
  • When documenting a follow-up visit for an existing injury.
  • When documenting complications of an injury.
  • When documenting a patient's medical history of injuries to the knee or lower leg.

When NOT to Use:

  • When the injury is not to the knee or lower leg.
  • When the injury is an open wound without damage to the underlying structures.
  • When the injury is a superficial injury without damage to the underlying structures.
  • When the injury is a burn.

Code Exclusions

Always verify exclusions with the latest version of the ICD-10-CM.

Documentation Requirements

Accurate documentation is crucial for coding injuries to the knee and lower leg. The documentation should provide detailed information about the injury, including its cause, location, and nature.

Clinical Information:

  • Specific location of the injury.
  • Nature of the injury (fracture, dislocation, sprain, etc.).
  • Cause of the injury.
  • Any associated complications.
  • Any associated open wounds.

Supporting Evidence:

  • Medical history.
  • Physical examination findings.
  • Imaging studies.
  • Operative reports.
Good Documentation Example:

Patient presented with a comminuted fracture of the right tibia due to a fall from a ladder.

Poor Documentation Example:

Patient fell and broke leg.

Common Documentation Errors:

  • Not specifying the location of the injury.
  • Not specifying the nature of the injury.
  • Not documenting the cause of the injury.
  • Not documenting associated complications.

Range Statistics

10
Total Codes
0
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:19

Coding Complexity

Medium
Complexity Rating

Coding injuries to the knee and lower leg can be moderately complex due to the need to specify the location and nature of the injury, document any associated complications, and use additional codes as appropriate. However, with careful attention to detail and a thorough understanding of the ICD-10-CM, these codes can be used effectively.

Key Factors:
  • The need to specify the location and nature of the injury.
  • The need to document any associated complications.
  • The need to use additional codes for associated open wounds and retained foreign bodies.
  • The need to use follow-up and complication codes as appropriate.

Specialty Focus

These codes are most commonly used by orthopedic surgeons, emergency medicine physicians, and primary care providers.

Primary Specialties:
Orthopedic Surgery
60%
Emergency Medicine
30%
Primary Care
10%
Clinical Scenarios:
  • A patient presents to the emergency department with a compound fracture of the tibia due to a motor vehicle accident.
  • A patient presents to the orthopedic clinic for follow-up after surgery for a dislocated knee.
  • A patient presents to the primary care clinic with a sprained ankle from a sports injury.
  • A patient presents to the emergency department with a crush injury to the lower leg from a workplace accident.
  • A patient presents to the orthopedic clinic with complications from a previous fracture of the fibula.

Resources & References

There are many resources available to help with coding injuries to the knee and lower leg.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Academy of Orthopaedic Surgeons ICD-10 Coding Guide
  • American College of Emergency Physicians ICD-10 Coding Guide

Clinical References:

  • Harrison's Principles of Internal Medicine
  • Campbell's Operative Orthopaedics

Educational Materials:

  • American Health Information Management Association ICD-10 Training
  • American Academy of Professional Coders ICD-10 Training

Frequently Asked Questions

Can I use a code from the S160-S169 range for an open wound without damage to the underlying structures?

No, for an open wound without damage to the underlying structures, use a code from the S01-S09 range instead.