S86.029A — Laceration of unspecified Achilles tendon, initial encounter
Is S86.029A billable?
Yes, but S86.029A will trip a Medicare edit. S86.029A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S86.029A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
S86.029A at a glance
| Code | S86.029A |
|---|---|
| Description | Laceration of unspecified Achilles tendon, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in S86.029A?
In S86.029A, the 7th character A means initial encounter. The 7th character is required for S86.029A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S86.029A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S86.029A directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does S86.029A group to?
S86.029A sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S86.029A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S86.029A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S86.02, the nearest indexed parent of S86.029A. Use them to find the family, then select the specific code.
- Laceration › Achilles tendon
- Injury › Achilles tendon › laceration
- Laceration › tendon › Achilles
Use additional code — inherited from Chapter 19
Report an additional code alongside S86.029A to fully describe the condition. S86.029A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of S86.029A, but a patient may have both at the same time. When documentation supports it, S86.029A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S80-S89
The conditions below are not part of S86.029A, but a patient may have both at the same time. When documentation supports it, S86.029A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S86
The conditions below are not part of S86.029A, but a patient may have both at the same time. When documentation supports it, S86.029A and the excluded code may both be reported.
Code also — inherited from S86
Two codes may be needed to describe the condition fully. Whether S86.029A is sequenced first depends on the reason for the encounter.
- any associated open wound (S81.-)
How long has S86.029A existed?
S86.029A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.