ICD-10 Coding for Plantar Plate Tear(M24.174, S93.525A)
Complete ICD-10-CM coding and documentation guide for Plantar Plate Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Plantar Plate Tear
M24.1-M24.2Primary Range
Other specific joint derangements and disorders of ligament
Covers degenerative and spontaneous tears of the plantar plate.
Sprain and strain of joints and ligaments of ankle and foot
Used for traumatic tears of the plantar plate.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M24.174 | Other articular cartilage disorders, right foot | For chronic or degenerative tears without trauma on the right foot. |
|
| S93.525A | Sprain of metatarsophalangeal joint of right foot, initial encounter | For acute traumatic tears of the plantar plate. |
|
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 plantar plate tear
Essential facts and insights about Plantar Plate Tear
Primary ICD-10-CM Codes for plantar plate tear
Decision Criteria
clinical Criteria
- Chronic symptoms with MRI confirmation
Applicable To
- Chronic degenerative tear of plantar plate
Excludes
- Traumatic tear (S93.525)
Clinical Validation Requirements
- MRI showing high T2 signal at phalangeal attachment
- Positive drawer test
Code-Specific Risks
- Incorrectly coding as traumatic tear
Coding Notes
- Ensure documentation specifies laterality and etiology.
S93.525A - Sprain of metatarsophalangeal joint of right foot, initial encounter
For acute traumatic tears of the plantar plate.
Applicable To
- Traumatic tear of plantar plate
Excludes
- Degenerative tear (M24.174)
Clinical Validation Requirements
- Acute injury mechanism
- Positive drawer test
Coding Notes
Specify the encounter type with the appropriate 7th character.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Disorder of ligament, right foot
M24.274Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Plantar Plate Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M24.174.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit issues., Financial: Denied claims and delayed reimbursement.
Mitigation Strategy
Verify the etiology and laterality before coding.
Impact
Reimbursement: Claims may be denied due to unspecified laterality., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always specify right or left foot in documentation.
Impact
High rejection rate for claims using CPT 28899 without detailed documentation.
Mitigation Strategy
Ensure comprehensive operative reports are submitted with claims.
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 Plantar Plate Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Plantar Plate Tear
Use these documentation templates to ensure complete and accurate documentation for Plantar Plate Tear. These templates include all required elements for proper coding and billing.
Chronic degenerative tear repair
Specialty: PodiatryRequired Elements
- Procedure description
- Operative findings
- Postoperative diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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