ICD-10 Coding for Left Knee ACL Tear(S83.512A, S83.512D)
Complete ICD-10-CM coding and documentation guide for Left Knee ACL Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Knee ACL Tear
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S83.512A | Sprain of anterior cruciate ligament of left knee, initial encounter | Use for acute injuries of the left ACL confirmed by imaging or physical examination. |
|
| S83.512D | Sprain of anterior cruciate ligament of left knee, subsequent encounter | Use for follow-up visits after initial treatment of an ACL tear. |
|
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 left knee ACL tear
Essential facts and insights about Left Knee ACL Tear
Primary ICD-10-CM Codes for left knee acl tear
Decision Criteria
clinical Criteria
- Confirmed acute tear via MRI
documentation Criteria
- Documentation must specify left knee and encounter type
Applicable To
- Acute tear of left ACL
Excludes
- Chronic instability of knee (M23.5-)
Clinical Validation Requirements
- MRI confirmation of ACL tear
- Positive Lachman test
Code-Specific Risks
- Incorrect laterality
- Misclassification of encounter type
Coding Notes
- Ensure documentation specifies 'tear' or 'sprain' and laterality.
S83.512D - Sprain of anterior cruciate ligament of left knee, subsequent encounter
Use for follow-up visits after initial treatment of an ACL tear.
Applicable To
- Follow-up for left ACL tear
Clinical Validation Requirements
- Ongoing treatment for ACL tear
Coding Notes
Ensure encounter type is documented as subsequent.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Old disruption of anterior cruciate ligament
M23.512Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Knee ACL Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.512A.
Impact
Clinical: Inaccurate treatment tracking., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document encounter type in patient records.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always specify left or right knee in documentation and coding.
Impact
Failure to document encounter type accurately.
Mitigation Strategy
Implement checklist for encounter documentation.
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 Left Knee ACL Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Knee ACL Tear
Use these documentation templates to ensure complete and accurate documentation for Left Knee ACL Tear. These templates include all required elements for proper coding and billing.
Acute ACL Tear
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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