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S83.249A
ICD-10-CM
Medial Meniscus Tear

Find information on medial meniscus tear diagnosis, including clinical documentation, ICD-10 codes (S83.2_), and medical coding guidelines. Learn about healthcare resources for meniscus injuries, treatment options, and post-operative care. Explore accurate medical coding for medial meniscus tear, MRI findings for meniscus tears, and differential diagnosis considerations. This resource provides essential information for physicians, coders, and healthcare professionals dealing with meniscus tear documentation and coding.

Also known as

Medial Meniscus Injury
Meniscal Tear

Diagnosis Snapshot

Key Facts
  • Definition : Tear in the cartilage of the inner knee, often caused by twisting.
  • Clinical Signs : Knee pain, swelling, popping, locking, limited range of motion.
  • Common Settings : Sports injuries, degenerative changes, sudden twisting motions.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S83.249A Coding
S83.2-

Medial Meniscus Tear

Tear of the medial meniscus of the knee.

M23.-

Internal derangement of knee

Includes various knee joint problems like tears or displacements.

S83.-

Other knee injuries

Encompasses other injuries to the knee not classified elsewhere.

Code-Specific Guidance

Decision Tree for

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

Is the medial meniscus tear traumatic?

  • Yes

    Is it acute or chronic?

  • No

    Which knee? Left or Right?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Medial Meniscus Tear
Lateral Meniscus Tear
Meniscus Degeneration

Documentation Best Practices

Documentation Checklist
  • Document mechanism of injury (e.g., twisting, trauma)
  • Specify location of tear (medial meniscus)
  • Describe any locking, clicking, or instability
  • Assess range of motion and tenderness
  • Note McMurray's test result (positive/negative)

Coding and Audit Risks

Common Risks
  • Meniscus Laterality

    Incorrect coding for the affected side (right, left, unspecified) leading to claim denials or inaccurate data reporting. ICD-10 specificity important for medical coding audits.

  • Tear Acuity Mismatch

    Discrepancy between documented tear acuity (acute, chronic, unspecified) and coded diagnosis. Impacts reimbursement and CDI queries for healthcare compliance.

  • Unspecified vs. Specified Tear

    Using unspecified meniscus tear code when documentation supports a more specific location (e.g., anterior horn, posterior horn). Affects medical coding accuracy and data analysis for quality measures.

Mitigation Tips

Best Practices
  • Document mechanism of injury, physical exam, McMurray's test results for accurate ICD-10 coding (S73.2)
  • Specify tear type (e.g., bucket-handle, radial) and location (anterior horn, posterior horn) in operative notes for optimal reimbursement.
  • Correlate MRI findings with clinical symptoms for improved CDI and support medical necessity for arthroscopy (CPT 29880-29883).
  • Ensure precise documentation of meniscal repair vs. meniscectomy for proper CPT code assignment and compliance.
  • Query physician for clarification if documentation lacks detail impacting code selection and accurate reporting.

Clinical Decision Support

Checklist
  • Joint line tenderness: Document medial joint line palpation.
  • McMurray test: Positive click/pop? Document test details.
  • Thessaly test: Pain/locking at 5/20 degrees flexion?
  • Imaging: Order/review MRI for meniscus tear confirmation.

Reimbursement and Quality Metrics

Impact Summary
  • Medial Meniscus Tear: Coding accuracy impacts reimbursement for arthroscopy, meniscectomy, repair.
  • ICD-10 S13.2-, S13.3- accurate coding crucial for appropriate hospital MS-DRG assignment.
  • Precise documentation of tear type (acute, chronic, complex) affects payment and quality metrics.
  • Tracking meniscus repair rates vs meniscectomy influences hospital quality reporting and value-based care.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Code meniscus tear laterality
  • Document mechanism of injury
  • Specify acute or chronic tear
  • Include MRI findings for dx confirmation
  • Add any associated cartilage damage

Documentation Templates

Patient presents with complaints consistent with medial meniscus tear.  Onset of symptoms occurred during [activity causing injury - e.g., twisting injury while playing basketball] approximately [duration - e.g., two weeks] ago.  Patient reports [character of pain - e.g., sharp, aching] pain localized to the [location - e.g., medial aspect of the right knee].  Pain is exacerbated by [aggravating factors - e.g., weight-bearing, flexion, and internal rotation].  Patient also reports [associated symptoms - e.g., clicking, popping, locking, swelling, stiffness, and instability].  Physical examination reveals [objective findings - e.g., tenderness to palpation along the medial joint line, positive McMurray's test, and limited range of motion].  Differential diagnosis includes medial meniscus injury, ligamentous injury, osteoarthritis, and patellofemoral pain syndrome.  Preliminary diagnosis of medial meniscus tear is suspected.  Plan includes [imaging studies - e.g., MRI of the right knee] to confirm the diagnosis and assess the extent of the tear.  Conservative management may include [conservative treatments - e.g., rest, ice, compression, elevation, physical therapy, and NSAIDs].  If conservative treatment fails, surgical intervention such as [surgical options - e.g., meniscus repair or partial meniscectomy] may be considered.  Patient education provided regarding the diagnosis, treatment options, and expected prognosis.  Follow-up appointment scheduled in [duration - e.g., two weeks] to review imaging results and discuss further management.  ICD-10 code: [relevant ICD-10 code - e.g., M23.211] pending confirmation of diagnosis.  CPT codes for evaluation and management will be determined based on the complexity of the visit.
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