Feel the Love for Tennis Elbow Coding
Question: The provider saw an established 13-year-old patient who was experiencing a sharp pain in their left elbow. After a brief history and exam, the practitioner ordered a two-view elbow X-ray to rule out a fracture. The final diagnosis was lateral epicondylitis of the left elbow. How should I report this encounter? Revenue Cycle Insider Subscriber Answer: On the claim, you’ll report 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.) for the evaluation and management (E/M) portion of the encounter. You’ll also add 73070 (Radiologic examination, elbow; 2 views) for the X-ray, assuming the practice provided the X-ray ordered by the physician (including both the technical and professional components) and it was not performed at another location. Also, append modifier LT (Left side) to 73070. When it comes to coding lateral epicondylitis, also known as tennis elbow, which is a painful inflammation of the tendons that join the forearm muscles on the outside of the elbow, you’ll look to the M77.1- (Lateral epicondylitis) section of the ICD-10-CM code book. These are the codes available for the condition: Since your provider indicated that the patient suffered from lateral epicondylitis, or tennis elbow, of the left elbow, the ICD-10-CM code to append to 99213 and 73070 is M77.12. Make note: M77.0- (Medial epicondylitis) Medial epicondylitis, also known as golfer’s elbow, is another common form of painful inflammation of the tendons that join the forearm muscles on the inner side of the elbow. Both tennis elbow and golfer’s elbow often occur due to overuse or repeated injury. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
