ICD-10 Coding for Tear of the Medial Meniscus(S83.22XA, M23.261)
Complete ICD-10-CM coding and documentation guide for Tear of the Medial Meniscus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tear of the Medial Meniscus
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S83.22XA | Tear of medial meniscus, current injury, initial encounter | Use for acute traumatic tears confirmed by imaging and clinical examination. |
|
| M23.261 | Derangement of medial meniscus due to old tear or injury | Use for chronic or degenerative tears without recent trauma. |
|
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 medial meniscus tear
Essential facts and insights about Tear of the Medial Meniscus
Primary ICD-10-CM Codes for tear of the medial meniscus
Decision Criteria
clinical Criteria
- Acute onset with a clear traumatic event
documentation Criteria
- MRI confirmation of medial meniscus tear
Applicable To
- Acute traumatic tear of medial meniscus
Excludes
- Chronic tear of medial meniscus (M23.2)
Clinical Validation Requirements
- Mechanism of injury (e.g., twisting)
- MRI confirmation of tear
- Clinical signs such as joint line tenderness
Code-Specific Risks
- Incorrectly coding as chronic if acute nature is not documented
Coding Notes
- Ensure documentation specifies 'acute' and includes imaging confirmation.
M23.261 - Derangement of medial meniscus due to old tear or injury
Use for chronic or degenerative tears without recent trauma.
Applicable To
- Chronic degenerative tear of medial meniscus
Excludes
- Acute tear of medial meniscus (S83.2)
Clinical Validation Requirements
- History of knee problems without recent trauma
- MRI showing degenerative changes
Coding Notes
Document chronicity and lack of recent trauma.
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 Tear of the Medial Meniscus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S83.22XA.
Impact
Clinical: Ambiguity in treatment planning, Regulatory: Non-compliance with ICD-10 requirements, Financial: Potential claim denials
Mitigation Strategy
Always specify right or left in clinical notes, Use templates that prompt for laterality
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies the acute nature and includes imaging findings.
Impact
Risk of audits due to misclassification of acute vs. chronic tears.
Mitigation Strategy
Implement thorough documentation practices and regular training.
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 Tear of the Medial Meniscus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tear of the Medial Meniscus
Use these documentation templates to ensure complete and accurate documentation for Tear of the Medial Meniscus. These templates include all required elements for proper coding and billing.
Acute traumatic medial meniscus tear
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Clinical examination findings
- MRI results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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