Meniscus tears

Good morning,

ICD 10 question --- does anyone have any information or guidelines on how
to code for meniscus tears?

There are three different sections for these tears and I just need
clarification on how to use them. Please see the below questions.

1.Traumatic current injury; example S83.239A---*What is considered current?
If the injury happened one or more years ago but patient comes in now for
treatment of it, would it be appropriate to bill with the S-Code traumatic?
How many days or months is considered current?*

2.Derangement due to old tear or injury; example M23.200* ---What is
considered old? When would you use this code?*

3.Degenerative; example M23.300-* is this for degenerative tears?*

*Any help is greatly appreciated.*

Thanks in advance,

*Barbara Butler, CPC, CGSC*
Certified Coder
Fox Valley Orthopaedic Institute
2525 Kaneville Road Geneva, IL 60134
Direct (630) 524-0144 | Main (630) 584-1400

Comments

  • edited May 2017
    Hi Barbara,

    Here is a story we had 2 years ago in the Orthopedic Coder’s Pink Sheet. Perhaps it will help:

    Document acute or chronic for appropriate meniscal tear coding in I-9, I-10
    by: Laura Evans, CPC
    Published May 1, 2015
    Last Reviewed Apr 24, 2015
    You will need to query the surgeon on whether meniscus tears are acute or chronic if you find yourself in the common situation where that information is not specified in the documentation.

    That’s according to two official ICD-10 resources: The ICD-10-CM Official Guidelines for coding and Reporting and the AHA ICD-10 Coding Clinic. The guidelines instruct you to refer to codes from Chapter 13 (Diseases of the musculoskeletal system and connective tissue [M00-M99]) when:

    * the condition is the result of a healed injury or
    * it’s a chronic or recurrent injury.
    In ICD-9, those situations were referred to as old meniscal tears (Category 717). In ICD-10, you’re referred to internal derangement of knee (M23), where you’ll select the specific code depending on the type of tear and the site.

    For example, “If after query, the physician confirms that the documented posterior horn medial meniscus tear is the result of an old injury, assign from category M23.22x” (Derangement of posterior horn of medial meniscus due to old tear or injury), the AHA Coding Clinic advised. “Or if the physician confirms the tear is a result of degeneration, assign from category M23.32x” (Other meniscus derangements, posterior horn of medial meniscus).

    Code current tears from injury chapter

    For acute or “current” meniscal tears, in ICD-9 you refer to codes 836.0 (Tear of medial cartilage or meniscus of knee, current), 836.1 (Lateral meniscus tear, current) or 836.2 (Other meniscus tear, current).

    In ICD-10, look at codes from Chapter 19 (Injury, poisoning and certain other consequences of external causes [S00-T88]) for any acute injury.

    You’ll find quite a few more codes to choose from under S83.2 (Tear of meniscus, current injury). Select the code based on site and the type of tear and location: for example, S83.23x (Complex tear of medial meniscus, current injury).

    Keep in mind that for the ICD-10 acute injury codes, you must add a seventh character based on whether this is the patient’s initial encounter (A), subsequent encounter (D) or sequela (late effect [S]).

    Default to current injury if not specified

    If not stated one way or the other, code it as a current injury, Coding Clinic instructs.

    Tip: Let your surgeons know that documentation should indicate whether or not a meniscal tear is “current.”

    Some clues that it is a current injury: Documentation shows the injury is “acute on chronic” or the patient has “locked” knee or mechanical issues, points out OCPS technical adviser Margie Scalley Vaught, CPC, CPC-H, CCS-P, ACS-EM, ACS-OR. The reasoning is that now it has become an acute situation — even if there had been a previous chronic injury.


    Laura Evans, CPC
    Editor
    Orthopedic Coder’s Pink Sheet
    selectcoder.decisionhealth.com

    p: 855-225-5341 x6019
    e: levans@decisionhealth.com
  • Thank you.
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