ICD-10 Coding for Bankart Lesion(S43.431A)
Complete ICD-10-CM coding and documentation guide for Bankart Lesion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bankart Lesion
S43.43Primary Range
Dislocation of shoulder joint
This range includes codes specific to Bankart lesions with laterality and encounter specificity.
Key Information: ICD-10 code for Bankart lesion
Essential facts and insights about Bankart Lesion
Primary ICD-10-CM Code for bankart lesion
Decision Criteria
clinical Criteria
- Confirmed anteroinferior labral tear via imaging
documentation Criteria
- Documentation must specify laterality and encounter type
Applicable To
- Anteroinferior labral tear
Excludes
- SLAP lesion
Clinical Validation Requirements
- MRI or arthroscopy confirming anteroinferior labral tear
- History of anterior shoulder dislocation
Code-Specific Risks
- Confusion with SLAP lesions
- Incorrect laterality documentation
Coding Notes
- Ensure documentation specifies laterality and encounter type.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Anterior dislocation of shoulder joint
S43.08xADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other shoulder lesions
M75.81Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bankart Lesion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.431A.
Impact
Clinical: Inaccurate treatment records, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use templates that prompt for laterality, Review documentation before submission
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate medical records.
Mitigation Strategy
Ensure documentation specifies the location of the labral tear.
Impact
Improper use of modifier 59 when coding Bankart and SLAP repairs.
Mitigation Strategy
Ensure documentation supports separate procedures.
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 Bankart Lesion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bankart Lesion
Use these documentation templates to ensure complete and accurate documentation for Bankart Lesion. These templates include all required elements for proper coding and billing.
Operative Note for Bankart Repair
Specialty: Orthopedic SurgeryRequired Elements
- Pre-op diagnosis
- Operative findings
- Procedure details
- Post-op diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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