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S83.90XA
ICD-10-CM
Knee Sprain

Find information on knee sprain diagnosis, including clinical documentation, medical coding, ICD-10 codes, and treatment. Learn about the different grades of knee sprains, lateral collateral ligament sprain, medial collateral ligament sprain, and anterior cruciate ligament injuries. This resource provides guidance for healthcare professionals on proper documentation and coding for knee sprain injuries for accurate reimbursement and patient care. Explore knee sprain symptoms, causes, and diagnostic tests.

Also known as

Knee Ligament Sprain
Cruciate Ligament Injury
Collateral Ligament Sprain

Diagnosis Snapshot

Key Facts
  • Definition : Stretching or tearing of knee ligaments.
  • Clinical Signs : Pain, swelling, stiffness, instability, limited range of motion.
  • Common Settings : Sports injuries, falls, awkward twisting motions.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S83.90XA Coding
S83

Sprains and strains of knee and leg

Covers sprains and strains affecting the knee and leg area.

S80-S89

Injuries to the knee and lower leg

Includes various injuries like fractures, dislocations, and sprains in the knee and lower leg.

M23

Internal derangements of knee

Includes internal knee problems like meniscus tears that may accompany a sprain.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the knee sprain traumatic?

  • Yes

    Current injury?

  • No

    Consider other diagnoses. Sprain is by definition traumatic. Review documentation for alternative diagnosis or clarification.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Knee ligament stretch or tear
Knee meniscus tear
Knee contusion

Documentation Best Practices

Documentation Checklist
  • Knee sprain laterality (left/right)
  • Detailed injury mechanism
  • Specific anatomical location
  • Grade of the sprain (I, II, III)
  • Objective physical exam findings

Coding and Audit Risks

Common Risks
  • Unspecified Laterality

    Coding knee sprain without specifying right, left, or bilateral can lead to claim denials and inaccurate reporting. Use ICD-10 laterality codes.

  • MCL/LCL/ACL/PCL Clarity

    Lack of documentation specifying which ligament is sprained (MCL, LCL, ACL, PCL) leads to coding errors and impacts severity reflection.

  • Sprain vs. Tear/Strain

    Incorrectly coding a tear or strain as a sprain or vice-versa, based on vague documentation, leads to inaccurate severity and reimbursement.

Mitigation Tips

Best Practices
  • Document laterality, mechanism of injury, and severity for accurate ICD-10 coding (S73.-).
  • Use precise physical exam details: range of motion, tenderness, effusion, instability. Improves CDI.
  • Order appropriate imaging (X-ray, MRI) per clinical guidelines. Ensures compliance, justifies diagnosis.
  • Differentiate between strain and sprain. Specific documentation impacts coding, billing compliance.
  • For chronic instability, document prior sprains, treatments, and functional limitations. Aids HCC coding.

Clinical Decision Support

Checklist
  • Confirm mechanism of injury consistent with sprain (twisting, direct blow)
  • Palpate for tenderness, swelling, and instability around the knee joint
  • Assess range of motion and ligament integrity (Lachman, McMurray tests)
  • Evaluate for fractures via X-ray if Ottawa Knee Rules positive

Reimbursement and Quality Metrics

Impact Summary
  • Knee Sprain reimbursement hinges on accurate ICD-10 coding (S83.-) and appropriate CPT codes for evaluation and management, procedures, and DME. Impacts coding accuracy, denials, and revenue cycle.
  • Proper documentation of severity, laterality, and mechanism of injury impacts Knee Sprain reimbursement. Thorough documentation supports medical necessity for optimal payment.
  • Timely filing and correct coding of Knee Sprain diagnoses affect hospital reporting metrics like average reimbursement per case and denial rates. Improves revenue cycle management.
  • Accurate Knee Sprain coding impacts quality metrics related to patient outcomes, pain management, and return to function. Data-driven insights improve care quality.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Lateral/medial meniscus codes check
  • ACL/PCL injury - add if present
  • Grade sprain (I, II, III) crucial
  • ICD-10 S73 code category main
  • 719.xx knee pain add for context

Documentation Templates

Patient presents with complaints consistent with a knee sprain.  Onset of symptoms occurred on [Date of onset] following [Mechanism of injury - e.g., twisting injury while playing basketball, fall].  Patient reports [Character of pain - e.g., sharp, aching] pain localized to the [Location of pain - e.g., medial aspect of the right knee, lateral left knee].  Pain is aggravated by [Aggravating factors - e.g., weight-bearing, flexion].  Patient denies any popping or clicking sensations.  Physical examination reveals [Objective findings - e.g., tenderness to palpation along the medial joint line, mild effusion, full range of motion with some discomfort at end range].  Ligamentous testing demonstrates [Results of ligamentous tests - e.g., negative anterior drawer and Lachman tests, positive valgus stress test at 30 degrees].  No obvious deformity or crepitus noted.  Neurovascular examination is intact.  Assessment: Knee sprain, likely [Grade of sprain - e.g., Grade I, Grade II] of the [Specific ligament involved - e.g., medial collateral ligament].  Differential diagnoses include meniscus tear, patellar subluxation, and fracture.  Plan: RICE protocol (rest, ice, compression, elevation) is recommended.  Patient advised to avoid weight-bearing as tolerated and use crutches as needed.  NSAIDs prescribed for pain management.  Referral to physical therapy for rehabilitation.  Follow-up scheduled in [Duration - e.g., one week] to assess progress.  ICD-10 code: [Appropriate ICD-10 code - e.g., S83.401A Sprain of unspecified part of right knee, initial encounter].
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