ICD-10 Coding for Knee Injury(S83.511A, S83.251A)
Complete ICD-10-CM coding and documentation guide for Knee Injury. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Knee Injury
S83.2-S83.5Primary Range
Dislocation and sprain of joints and ligaments of knee
Covers common knee injuries such as ACL sprains and meniscus tears.
Fracture of lower leg, including ankle
Includes fractures that may accompany knee injuries.
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 acute traumatic ACL sprains confirmed by imaging and physical exam. |
|
| S83.251A | Bucket-handle tear of lateral meniscus, current injury, right knee, initial encounter | Use for acute bucket-handle tears confirmed by clinical exam and MRI. |
|
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 sprain
Essential facts and insights about Knee Injury
Primary ICD-10-CM Codes for knee injury
Decision Criteria
clinical Criteria
- Confirmed ACL tear on MRI
documentation Criteria
- Documented acute injury with mechanism of trauma
Applicable To
- Acute ACL sprain
Excludes
- Chronic instability of knee (M23.5-)
Clinical Validation Requirements
- MRI showing fiber discontinuity
- ≥5mm side-to-side laxity on KT-1000 arthrometer
Code-Specific Risks
- Incorrect laterality
- Missing 7th character
Coding Notes
- Ensure documentation specifies laterality and encounter type.
S83.251A - Bucket-handle tear of lateral meniscus, current injury, right knee, initial encounter
Use for acute bucket-handle tears confirmed by clinical exam and MRI.
Applicable To
- Acute bucket-handle tear
Excludes
- Old bucket-handle tear (M23.2-)
Clinical Validation Requirements
- Joint line tenderness
- Positive McMurray test
- MRI showing fluid signal extension
Coding Notes
Ensure documentation specifies the type of tear and encounter type.
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 Knee Injury 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 denials.
Mitigation Strategy
Train staff on the importance of external cause codes., Implement checklist for injury documentation.
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always verify and document the correct side of the injury.
Impact
Reimbursement: Claims may be rejected., Compliance: Violation of ICD-10 coding guidelines., Data Quality: Incomplete coding data.
Mitigation Strategy
Ensure the 7th character is added to indicate the encounter type (e.g., initial, subsequent).
Impact
Failure to use the correct 7th character can lead to audit issues.
Mitigation Strategy
Implement regular training and audits to ensure compliance.
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 Knee Injury, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Knee Injury
Use these documentation templates to ensure complete and accurate documentation for Knee Injury. These templates include all required elements for proper coding and billing.
Acute ACL sprain during sports
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Knee Injury? Ask your questions below.