ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
DiagnosesAchilles Tendon Strain

Achilles Tendon Strain

ICD-10 Coding for Achilles Tendon Strain(S86.011A, S86.012A)

PRIMARY SPECIALTYOrthopedics
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Achilles Tendon Strain?
Achilles tendon strain refers to an injury to the Achilles tendon, which connects the calf muscles to the heel bone. This condition often arises from overuse, sudden increases in physical activity, or improper footwear. Key clinical points include: 1) Commonly occurs in athletes, particularly runners; 2) Symptoms include pain, swelling, and stiffness in the back of the ankle; 3) Diagnosis is typically made through physical examination and imaging studies such as ultrasound or MRI; 4) Treatment may involve rest, ice, compression, elevation (RICE), and physical therapy. The etiology often involves repetitive stress or acute trauma, leading to microtears in the tendon fibers. Clinically, patients may present with localized pain, tenderness, and difficulty in performing activities that require ankle movement, particularly plantar flexion. Typical use cases for this diagnosis code include sports injuries, occupational injuries in physically demanding jobs, and cases resulting from sudden changes in activity levels.

Key Clinical Considerations:

  • Diagnosis requires a thorough clinical evaluation, including a detailed history of the injury and physical examination findings.
  • Signs and symptoms include pain along the tendon, swelling, and possible crepitus during movement.
  • Resolution criteria involve the absence of pain during activity and restoration of full range of motion.
  • Imaging findings may include thickening of the tendon, partial tears, or fluid accumulation around the tendon.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Documentation must include a clear description of the injury mechanism, symptoms, and physical exam findings.
  • Compliant documentation examples: 'Patient reports pain in the Achilles tendon after running' vs. non-compliant: 'Patient has pain'.
  • Template phrases include: 'Patient diagnosed with Achilles tendon strain based on clinical findings of tenderness and swelling'.
  • Medical necessity documentation should justify the need for imaging or referral to physical therapy.

Coding Guidelines

Usage Guidelines & Examples

  • Use this code when a patient presents with a confirmed diagnosis of Achilles tendon strain following a specific injury event.
  • Do not use this code for generalized ankle pain without specific findings related to the Achilles tendon.
  • Correct usage example: 'Patient diagnosed with S86.011A after presenting with acute pain post-exercise'; incorrect: 'Patient has ankle pain'.
  • Common errors include misclassifying the injury type or failing to document the mechanism of injury.

Code Exclusions

Important Exclusions

  • Excluded conditions include complete Achilles tendon ruptures (S86.00) and chronic tendinopathy (M76.60).
  • Alternative codes for exclusions may include S86.00 for ruptures or M76.60 for chronic issues.
  • Common exclusion errors involve misdiagnosing a strain as a rupture without appropriate imaging.
  • Certain conditions are excluded due to differing treatment protocols and clinical management strategies.

Related ICD-10 Codes

Primary Codes
S86.011A
Strain of right Achilles tendon, initial encounter
S86.012A
Strain of left Achilles tendon, initial encounter
Ancillary Codes
W00.0XXA
Differential Codes
M76.6
S86.112A

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • This diagnosis applies to athletes, individuals with sudden increases in activity, and those with a history of Achilles tendon issues.
  • Appropriate in clinical scenarios involving acute injuries during sports or physical labor.
  • Applicable in both outpatient and emergency settings, particularly in sports medicine practices.
  • Specialty-specific considerations include orthopedic evaluations and rehabilitation protocols.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Achilles tendon strain diagnosed based on clinical findings of tenderness and swelling.'

Template 2

Template: 'Patient presents with pain and limited mobility consistent with Achilles tendon strain.'

Template 3

Template: 'Diagnostic criteria met: tenderness along the Achilles tendon and positive Thompson test.'

Template 4

Template: 'Treatment plan includes physical therapy and activity modification for Achilles tendon strain.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this code?

Documentation must include the mechanism of injury, clinical findings, and treatment plan.

When should this code be used vs similar codes?

Use this code for acute strains; consider M76.60 for chronic conditions.

What are common billing issues with this code?

Issues may arise from lack of detailed documentation or misclassification of the injury.

What procedures are commonly associated?

Related CPT codes may include physical therapy evaluations and ultrasound imaging.