ICD-10 Coding for Torn Meniscus(S83.221A, M23.21)
Complete ICD-10-CM coding and documentation guide for Torn Meniscus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Torn Meniscus
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S83.221A | Tear of medial meniscus, current injury, right knee, initial encounter | Use for acute tears with a clear traumatic event, confirmed by imaging. |
|
| M23.21 | Derangement of medial meniscus due to old tear or injury | Use for chronic tears with degenerative changes, not linked to a recent injury. |
|
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 torn meniscus
Essential facts and insights about Torn Meniscus
Primary ICD-10-CM Codes for torn meniscus
Decision Criteria
clinical Criteria
- Sudden knee pain after twisting or impact
documentation Criteria
- MRI shows radial tear in posterior horn
Applicable To
- Acute medial meniscus tear
Excludes
- Chronic meniscus tear (M23.2-)
Clinical Validation Requirements
- MRI confirmation of tear
- Documented mechanism of injury
Code-Specific Risks
- Incorrectly coding chronic tears as acute
Coding Notes
- Ensure documentation specifies laterality and tear type.
M23.21 - Derangement of medial meniscus due to old tear or injury
Use for chronic tears with degenerative changes, not linked to a recent injury.
Applicable To
- Chronic medial meniscus tear
Excludes
- Acute meniscus tear (S83.2-)
Clinical Validation Requirements
- History of knee pain without recent trauma
- MRI showing degenerative changes
Coding Notes
Document the chronicity and any associated degenerative changes.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Torn Meniscus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.221A.
Impact
Clinical: May lead to incorrect treatment planning., Regulatory: Non-compliance with ICD-10 coding rules., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always document the affected side, Use templates that prompt for laterality
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation clearly differentiates between acute and chronic conditions.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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 Torn Meniscus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Torn Meniscus
Use these documentation templates to ensure complete and accurate documentation for Torn Meniscus. These templates include all required elements for proper coding and billing.
Acute Meniscus Tear
Specialty: OrthopedicsRequired Elements
- Patient history
- 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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