ICD-10-CM Code for Hamstring Tear
The ICD-10-CM code for a hamstring tear is S76.3, which specifically designates injury of muscle, fascia and tendon of the posterior muscle group at thigh level 1.
Code Specificity and Clinical Context
The S76.3 code is used to capture hamstring injuries in administrative and registry databases, though you should be aware of important accuracy limitations:
- This code encompasses all hamstring injuries including muscle belly strains, proximal hamstring tendon avulsions at the ischial tuberosity, and distal tendon injuries 2
- The code does NOT distinguish between injury severity (partial vs. complete tears, degree of retraction, or specific tendons involved)
- Laterality must be specified with a 7th character extension (right, left, or bilateral)
Important Clinical Caveats
Coding Accuracy Issues
Administrative coding using ICD-10 has documented accuracy problems. In a Swedish nationwide registry study tracking hamstring injuries coded as S76.3, researchers found the code captured diagnosed cases but could not differentiate between operative and non-operative injuries without additional procedure codes 1. Similar accuracy concerns have been documented with other ICD-10 procedural codes, where institutional coding accuracy ranged from 72% to 100% depending on the facility 3.
When Additional Specificity Matters
For clinical decision-making, treatment planning, or research purposes, the S76.3 code alone is insufficient. You need:
- MRI findings to determine exact location (proximal vs. distal vs. muscle belly), degree of retraction, and number of tendons involved 2
- Procedure codes (NOMESCO classification NFL49 or equivalent) if surgical treatment was performed 1
- Clinical documentation specifying whether this is an acute injury, chronic injury, or re-injury
Practical Application
When documenting a hamstring tear:
- Use S76.3 with appropriate laterality modifier for billing and registry purposes
- Include detailed clinical documentation describing the specific anatomical location, severity, and chronicity
- Add procedure codes if surgical intervention is performed
- Recognize that registry data based solely on S76.3 may underestimate or misclassify injury patterns 1
The code serves its administrative purpose but should never replace detailed clinical documentation for treatment decisions or outcome tracking 2.