S96.022A: Laceration of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter

S96.022A, laceration of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 27 HCPCS Level II codes, including J1670 (Injection, tetanus immune globulin, human, up to 250 units), G0281 (Electrical stimulation, (unattended), to one or more…), G0329 (Electromagnetic therapy, to one or more areas for chronic…). 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 S96.022A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J1670Injection, tetanus immune globulin, human, up to 250 unitsSpecial coverage instructions apply—2
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—2
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
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
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—1
G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2250Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1

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

Medicare policy articles listing S96.022A

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 S96 diagnoses (Injury of muscle and tendon at ankle and foot level)

Frequently asked questions

Does Medicare cover S96.022A (Laceration of muscle and tendon of long flexor muscle of…)?

Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list S96.022A 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 S96.022A?

The Level II codes from the policies most specific to this diagnosis are J1670 (Injection, tetanus immune globulin, human, up to 250 units, 2 articles); G0281 (Electrical stimulation, (unattended), to one or more…, 2 articles); 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). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list S96.022A?

A57554 (Billing and Coding: Immune Globulins); A55909 (Billing and Coding: Wound Care); A52438 (Billing and Coding: Tetanus Immunization), and 1 more article.

What is ICD-10-CM code S96.022A?

S96.022A is the ICD-10-CM code for laceration of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter, in category S96 (Injury of muscle and tendon at ankle and foot level), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

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