ICD-10 Coding for Anterior Cruciate Ligament Repair(S83.511A, T84.410A)
Complete ICD-10-CM coding and documentation guide for Anterior Cruciate Ligament Repair. 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 Repair
S83.51-Primary Range
Sprain of anterior cruciate ligament of knee
Primary range for acute ACL injuries, including sprains and tears.
Mechanical complication of internal orthopedic device, implant, and graft
Used for complications related to ACL grafts, such as failures.
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 encounters of acute ACL sprains or tears on the right knee. |
|
| T84.410A | Mechanical complication of internal orthopedic device, implant, and graft, initial encounter | Use for complications related to ACL grafts, such as mechanical failures. |
|
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 repair
Essential facts and insights about Anterior Cruciate Ligament Repair
Primary ICD-10-CM Codes for anterior cruciate ligament repair
Decision Criteria
clinical Criteria
- Acute injury confirmed by MRI or physical exam
Applicable To
- Acute ACL tear
Excludes
- Chronic ACL tear (M23.5-)
Clinical Validation Requirements
- Positive Lachman's test
- MRI showing ACL disruption
Code-Specific Risks
- Incorrectly coding chronic tears as acute
Coding Notes
- Ensure documentation specifies acute nature and laterality.
T84.410A - Mechanical complication of internal orthopedic device, implant, and graft, initial encounter
Use for complications related to ACL grafts, such as mechanical failures.
Applicable To
- ACL graft failure
Excludes
- Infection of graft (T84.5-)
Clinical Validation Requirements
- Post-surgical instability
- MRI confirming graft failure
Coding Notes
Document specific mechanical issues and confirm with imaging.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chondroplasty
29877Differential 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 Anterior Cruciate Ligament Repair to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.511A.
Impact
Clinical: Incomplete injury documentation., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Always include external cause codes for injuries., Review coding guidelines for injury coding.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Use M23.5- for chronic tears and S83.51- for acute tears.
Impact
Inadequate documentation of mechanical failures can lead to audit issues.
Mitigation Strategy
Ensure detailed operative and imaging reports are included.
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 Repair, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anterior Cruciate Ligament Repair
Use these documentation templates to ensure complete and accurate documentation for Anterior Cruciate Ligament Repair. These templates include all required elements for proper coding and billing.
Primary ACL Reconstruction
Specialty: Orthopedic SurgeryRequired Elements
- Graft type and fixation method
- Operative findings
- Post-operative plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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