ICD-10 Guide

Tear Achilles Tendon

ICD-10 Coding for Tear of Achilles Tendon(S86.011A, M66.362)

PRIMARY SPECIALTYOrthopedics

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Tear Achilles Tendon?

Essential facts and insights about Tear of Achilles Tendon

Key Clinical Considerations:

Sudden pain in the back of the ankle or calf
Swelling and bruising around the heel
Inability to stand on tiptoes or push off the foot
Positive Thompson test

Clinical Information

Clinical Criteria & Documentation Requirements

Detailed patient history including mechanism of injury
Physical examination findings including range of motion
Imaging results (e.g., MRI or ultrasound) confirming the tear
Assessment of functional limitations

Coding Guidelines

Usage Guidelines & Examples

Ensure to differentiate between complete and partial tears for accurate coding.
Common errors include using incorrect laterality or encounter codes.

Code Exclusions

Important Exclusions

Partial tears of the Achilles tendon
Other tendon injuries or conditions affecting the ankle

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

Athletes and active individuals
Emergency departments and orthopedic clinics

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

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

Documentation requirements?

Include detailed injury description, physical exam findings, and imaging results.

Billing considerations?

Ensure correct ICD-10 codes are used and document all services provided.

Tear Achilles Tendon

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?

Tear Achilles Tendon

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?