ICD-10 Coding for Right ACL Tear(S83.511A)
Complete ICD-10-CM coding and documentation guide for Right ACL Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right ACL Tear
S83.51-S83.52Primary Range
Sprain and strain of knee and leg
This range includes codes for sprains and strains of the knee, specifically the anterior cruciate ligament (ACL).
Key Information: ICD-10 code for right ACL tear
Essential facts and insights about Right ACL Tear
Primary ICD-10-CM Code for right acl tear
Decision Criteria
clinical Criteria
- MRI confirmation of ACL tear
documentation Criteria
- Specify laterality and encounter type
Applicable To
- Complete tear of right ACL
- Partial tear of right ACL
Excludes
- Chronic instability of right knee (M23.51-)
Clinical Validation Requirements
- MRI confirmation of ACL tear
- Positive Lachman test
Code-Specific Risks
- Misclassification as a sprain without specifying tear
- Omission of laterality or encounter type
Coding Notes
- Ensure documentation specifies 'tear' rather than 'sprain' for accuracy.
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.
Sprain of anterior cruciate ligament of left knee, initial encounter
S83.512ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right ACL Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.511A.
Impact
Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify right or left in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Clarify with provider to specify 'tear' or 'sprain' and confirm with imaging.
Impact
Risk of audits due to missing laterality or encounter type.
Mitigation Strategy
Implement documentation checklists and regular audits.
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 Right ACL Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right ACL Tear
Use these documentation templates to ensure complete and accurate documentation for Right ACL Tear. These templates include all required elements for proper coding and billing.
Initial Evaluation of ACL Tear
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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