S86.929A — Laceration of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
Is S86.929A billable?
Yes, but S86.929A will trip a Medicare edit. S86.929A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S86.929A 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.
More specific alternatives
- S86.001AUnspecified injury of right Achilles tendon, initial encounter
- S86.101AUnspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, right leg, initial encounter
- S86.201AUnspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, right leg, initial encounter
- S86.301AUnspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, right leg, initial encounter
- S86.801AUnspecified injury of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter
S86.929A at a glance
| Code | S86.929A |
|---|---|
| Description | Laceration of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, 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 S86.929A?
In S86.929A, the 7th character A means initial encounter. The 7th character is required for S86.929A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S86.929A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S86.929A 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 S86.929A group to?
S86.929A 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, S86.929A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S86.929A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S86.92, the nearest indexed parent of S86.929A. Use them to find the family, then select the specific code.
- Injury › muscle › leg › laceration
Use additional code — inherited from Chapter 19
Report an additional code alongside S86.929A to fully describe the condition. S86.929A 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 S86.929A, but a patient may have both at the same time. When documentation supports it, S86.929A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S80-S89
The conditions below are not part of S86.929A, but a patient may have both at the same time. When documentation supports it, S86.929A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S86
The conditions below are not part of S86.929A, but a patient may have both at the same time. When documentation supports it, S86.929A and the excluded code may both be reported.
Code also — inherited from S86
Two codes may be needed to describe the condition fully. Whether S86.929A is sequenced first depends on the reason for the encounter.
- any associated open wound (S81.-)
How long has S86.929A existed?
S86.929A 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.