ICD-10 Coding for Anterior Cruciate Ligament Surgery(S83.51)
Complete ICD-10-CM coding and documentation guide for Anterior Cruciate Ligament Surgery. 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 Surgery
Key Information: ICD-10 code for ACL surgery
Essential facts and insights about Anterior Cruciate Ligament Surgery
Primary ICD-10-CM Code for anterior cruciate ligament surgery
Decision Criteria
clinical Criteria
- Acute injury with MRI confirmation
documentation Criteria
- Operative report detailing ACL reconstruction
Applicable To
- Complete ACL tear
- Partial ACL tear
Excludes
- Chronic instability of knee (M23.5)
Clinical Validation Requirements
- MRI report confirming ACL disruption
- Positive Lachman test
Code-Specific Risks
- Incorrectly coding chronic conditions as acute
- Missing documentation of injury mechanism
Coding Notes
- Ensure documentation specifies the acute nature of the injury.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for other orthopedic aftercare
Z47.89Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Chronic instability of knee
M23.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Anterior Cruciate Ligament Surgery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.51.
Impact
Clinical: Inadequate records for future care, Regulatory: Potential for audit issues, Financial: Denied claims or reduced reimbursement
Mitigation Strategy
Use standardized templates, Ensure all operative details are included
Impact
Reimbursement: Potential claim denials or reduced payments, Compliance: Risk of audits for incorrect coding, Data Quality: Inaccurate patient records
Mitigation Strategy
Ensure MRI and clinical findings support acute injury coding.
Impact
Incorrect use of modifiers for multiple procedures.
Mitigation Strategy
Review payer-specific guidelines for modifier application.
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 Surgery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anterior Cruciate Ligament Surgery
Use these documentation templates to ensure complete and accurate documentation for Anterior Cruciate Ligament Surgery. These templates include all required elements for proper coding and billing.
ACL Reconstruction with Meniscal Repair
Specialty: Orthopedic SurgeryRequired Elements
- Pre-operative diagnosis
- Operative findings
- Surgical technique
- Post-operative plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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