ICD-10 Coding for Lateral Meniscus Tear(S83.241A, M23.261)
Complete ICD-10-CM coding and documentation guide for Lateral Meniscus Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lateral Meniscus Tear
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S83.241A | Tear of lateral meniscus, current injury, right knee, initial encounter | Use for acute traumatic tears of the lateral meniscus in the right knee during the initial encounter. |
|
| M23.261 | Derangement of lateral meniscus due to old tear or injury, right knee | Use for chronic or degenerative tears of the lateral meniscus in the right knee. |
|
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 lateral meniscus tear
Essential facts and insights about Lateral Meniscus Tear
Primary ICD-10-CM Codes for lateral meniscus tear
Decision Criteria
clinical Criteria
- MRI confirmation of acute tear
documentation Criteria
- Documentation of trauma and laterality
Applicable To
- Acute lateral meniscus tear
- Traumatic lateral meniscus tear
Excludes
- Chronic lateral meniscus tear (M23.26-)
Clinical Validation Requirements
- MRI showing high-signal intensity extending to articular surface
- Acute trauma history
Code-Specific Risks
- Ensure laterality is documented
- Specify encounter type with 7th character
Coding Notes
- Ensure documentation specifies acute vs. chronic and includes laterality.
M23.261 - Derangement of lateral meniscus due to old tear or injury, right knee
Use for chronic or degenerative tears of the lateral meniscus in the right knee.
Applicable To
- Chronic lateral meniscus tear
- Degenerative lateral meniscus tear
Excludes
- Acute lateral meniscus tear (S83.24-)
Clinical Validation Requirements
- X-ray/MRI showing osteoarthritis
- Absence of trauma
- Symptoms >3 months
Coding Notes
Document chronicity and absence of recent trauma.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Tear of anterior cruciate ligament
S83.51-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 Lateral Meniscus Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.241A.
Impact
Clinical: Impacts treatment planning and follow-up., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or delays.
Mitigation Strategy
Standardize documentation templates to include laterality., Educate staff on importance of complete documentation.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Query: 'Is this tear traumatic or degenerative? Specify injury date/mechanism.'
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Fails to meet ICD-10 coding requirements., Data Quality: Incomplete coding data.
Mitigation Strategy
Add encounter type (e.g., S83.241A for initial encounter).
Impact
Using unspecified codes increases audit risk.
Mitigation Strategy
Ensure documentation is complete and specific.
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 Lateral Meniscus Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lateral Meniscus Tear
Use these documentation templates to ensure complete and accurate documentation for Lateral Meniscus Tear. These templates include all required elements for proper coding and billing.
Orthopedic Progress Note (Post-Op)
Specialty: OrthopedicsRequired Elements
- Pain levels
- Range of motion
- Specific interventions
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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