S86.921A: Laceration of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter

S86.921A, laceration of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 27 HCPCS Level II codes, including G0329 (Electromagnetic therapy, to one or more areas for chronic…), J1575 (Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg…), J1569 (Injection, immune globulin, (gammagard liquid/gammagard…). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with S86.921A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of careCarrier judgment—2
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—1
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—1
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—1
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—1
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—1
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—1
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1460Injection, gamma globulin, intramuscular, 1 ccSpecial coverage instructions apply—1
J1670Injection, tetanus immune globulin, human, up to 250 unitsSpecial coverage instructions apply—1
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 gramCarrier judgment—1
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vialSpecial coverage instructions apply—1
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—1
J1560Injection, gamma globulin, intramuscular, over 10 ccSpecial coverage instructions apply—1
J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 mlSpecial coverage instructions apply—1
J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 mlCarrier judgment—1
J1577Injection, immune globulin (qivigy), 100 mgCarrier judgment—1
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of careCarrier judgment—1
G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0157Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0159Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutesCarrier judgment—1

2 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing S86.921A

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other S86 diagnoses (Injury of muscle, fascia and tendon at lower leg level)

Frequently asked questions

Does Medicare cover S86.921A (Laceration of unspecified muscle(s) and tendon(s) at lower…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S86.921A as a covered diagnosis for 27 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 S86.921A?

The Level II codes from the policies most specific to this diagnosis are G0329 (Electromagnetic therapy, to one or more areas for chronic…, 2 articles); J1575 (Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg…, 1 article); J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 1 article); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 1 article); J1459 (Injection, immune globulin (privigen), intravenous…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list S86.921A?

A57554 (Billing and Coding: Immune Globulins); A55909 (Billing and Coding: Wound Care); A53058 (Billing and Coding: Home Health Physical Therapy).

What is ICD-10-CM code S86.921A?

S86.921A is the ICD-10-CM code for laceration of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter, in category S86 (Injury of muscle, fascia and tendon at lower leg level), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Compiled by Caduvo from public CMS (Medicare) records, ICD-10-CM FY2026, HCPCS release October 2026, 2026 fee schedule (non-rural state fees). Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup