ICD-10 Coding for Meniscal Tear(S83.22XA, M23.21)
Complete ICD-10-CM coding and documentation guide for Meniscal Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Meniscal 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 |
|---|---|---|---|
| S83.22XA | Tear of medial meniscus, current injury, initial encounter | Use for acute, traumatic medial meniscus tears. |
|
| M23.21 | Derangement of medial meniscus due to old tear or injury | Use for chronic meniscal tears with degenerative changes. |
|
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 meniscal tear
Essential facts and insights about Meniscal Tear
Primary ICD-10-CM Codes for meniscal tear
Decision Criteria
clinical Criteria
- Sudden onset of knee pain with trauma history
documentation Criteria
- MRI confirms medial meniscus tear
Applicable To
- Acute medial meniscus tear
Excludes
- Chronic meniscal tear (M23.2)
Clinical Validation Requirements
- MRI confirmation of tear
- Positive McMurray or Thessaly test
Code-Specific Risks
- Misclassification as chronic if not specified
Coding Notes
- Ensure documentation specifies 'acute' and 'traumatic'.
M23.21 - Derangement of medial meniscus due to old tear or injury
Use for chronic meniscal tears with degenerative changes.
Applicable To
- Chronic medial meniscus tear
Excludes
- Acute meniscal tear (S83.2)
Clinical Validation Requirements
- History of knee instability
- MRI showing degenerative changes
Coding Notes
Ensure documentation specifies 'chronic' and 'degenerative'.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Osteoarthritis of knee, unspecified
M17.9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Meniscal Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.22XA.
Impact
Clinical: Ambiguity in treatment plan, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always specify left or right knee, Use RT/LT modifiers
Impact
Reimbursement: Incorrect DRG assignment affecting payment, Compliance: Potential audit failure, Data Quality: Inaccurate clinical data
Mitigation Strategy
Ensure documentation includes 'acute' or 'traumatic'.
Impact
Reimbursement: Incorrect billing leading to denied claims, Compliance: Non-compliance with coding guidelines, Data Quality: Misleading patient history
Mitigation Strategy
Verify the timeline of the injury before coding.
Impact
Failure to document acuity can lead to incorrect coding.
Mitigation Strategy
Implement documentation checks for acuity specification.
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 Meniscal Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Meniscal Tear
Use these documentation templates to ensure complete and accurate documentation for Meniscal Tear. These templates include all required elements for proper coding and billing.
Acute Meniscal Tear
Specialty: OrthopedicsRequired Elements
- Patient age and gender
- Mechanism of injury
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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