ICD-10 Coding for Anterior Cruciate Ligament Sprain(S83.511A, S83.512A)
Complete ICD-10-CM coding and documentation guide for Anterior Cruciate Ligament Sprain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Anterior Cruciate Ligament Sprain
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S83.511A | Sprain of anterior cruciate ligament of right knee, initial encounter | Use for initial encounter of acute right ACL sprain. |
|
| S83.512A | Sprain of anterior cruciate ligament of left knee, initial encounter | Use for initial encounter of acute left ACL sprain. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for ACL sprain
Essential facts and insights about Anterior Cruciate Ligament Sprain
Primary ICD-10-CM Codes for anterior cruciate ligament sprain
Decision Criteria
clinical Criteria
- Confirmed by MRI and positive Lachman test.
documentation Criteria
- Specify laterality and encounter type.
Applicable To
- Acute sprain of right ACL
Excludes
- Chronic ACL insufficiency (M23.51)
Clinical Validation Requirements
- MRI confirmation of ligament discontinuity
- Positive Lachman test
Code-Specific Risks
- Incorrectly coding as dislocation
- Missing laterality
Coding Notes
- Ensure laterality and encounter type are documented.
S83.512A - Sprain of anterior cruciate ligament of left knee, initial encounter
Use for initial encounter of acute left ACL sprain.
Applicable To
- Acute sprain of left ACL
Excludes
- Chronic ACL insufficiency (M23.52)
Clinical Validation Requirements
- MRI confirmation of ligament discontinuity
- Positive Lachman test
Coding Notes
Ensure laterality and encounter type are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Anterior Cruciate Ligament Sprain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.511A.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Use specific anatomical terms, Include imaging results
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use S83.5- for acute traumatic tears.
Impact
Failure to specify laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory laterality checks in EHR.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Anterior Cruciate Ligament Sprain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anterior Cruciate Ligament Sprain
Use these documentation templates to ensure complete and accurate documentation for Anterior Cruciate Ligament Sprain. These templates include all required elements for proper coding and billing.
Orthopedic Progress Note
Specialty: OrthopedicsRequired Elements
- Subjective
- Objective
- Assessment
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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