Orthopedic Coding Alert

You’ll ditch your current 836.xx options and specify the type of meniscus tear.

A tear of meniscus occurs in the knee and is a common sport injury — and with the October 1, 2015 ICD-10 implementation date looming ahead, that means you need to learn how to report these injuries sooner rather than later.

ICD-9-CM Codes: Currently, you should report:

• 836.0, Tear of medial cartilage or meniscus of knee current
  
• 836.1, Tear of lateral cartilage or meniscus of knee current
  
• 836.2, Other tear of cartilage or meniscus of knee current
  

ICD-10-CM Codes: However, that changes in ICD-10-CM. Here are your options:

• S83.200-, Bucket-handle tear of unspecified meniscus, current injury, right knee
  
• S83.201-, Bucket-handle tear of unspecified meniscus, current injury, left knee
  
• S83.202-, Bucket-handle tear of unspecified meniscus, current injury, unspecified knee
  
• S83.203-, Other tear of unspecified meniscus, current injury, right knee
  
• S83.204-, Other tear of unspecified meniscus, current injury, left knee
  
• S83.205-, Other tear of unspecified meniscus, current injury, unspecified knee
  
• S83.206-, Unspecified tear of unspecified meniscus, current injury, right knee
  
• S83.207-, Unspecified tear of unspecified meniscus, current injury, left knee
  
• S83.209-, Unspecified tear of unspecified meniscus, current injury, unspecified knee
  
• S83.211-, Bucket-handle tear of medial meniscus, current injury, right knee
  
• S83.212-, Bucket-handle tear of medial meniscus, current injury, left knee
  
• S83.219-, Bucket-handle tear of medial meniscus, current injury, unspecified knee
  
• S83.221-, Peripheral tear of medial meniscus, current injury, right knee
  
• S83.222-, Peripheral tear of medial meniscus, current injury, left knee
  
• S83.229-, Peripheral tear of medial meniscus, current injury, unspecified knee
  
• S83.231-, Complex tear of medial meniscus, current injury, right knee
  
• S83.232-, Complex tear of medial meniscus, current injury, left knee
  
• S83.239-, Complex tear of medial meniscus, current injury, unspecified knee
  
• S83.241-, Other tear of medial meniscus, current injury, right knee
  
• S83.242-, Other tear of medial meniscus, current injury, left knee
  
• S83.249-, Other tear of medial meniscus, current injury, unspecified knee
  
• S83.251-, Bucket-handle tear of lateral meniscus, current injury, right knee
  
• S83.252-, Bucket-handle tear of lateral meniscus, current injury, left knee
  
• S83.259-, Bucket-handle tear of lateral meniscus, current injury, unspecified knee
  
• S83.261-, Peripheral tear of lateral meniscus, current injury, right knee
  
• S83.262-, Peripheral tear of lateral meniscus, current injury, left knee
  
• S83.269-, Peripheral tear of lateral meniscus, current injury, unspecified knee
  
• S83.271-, Complex tear of lateral meniscus, current injury, right knee
  
• S83.272-, Complex tear of lateral meniscus, current injury, left knee
  
• S83.279-, Complex tear of lateral meniscus, current injury, unspecified knee
  
• S83.281-, Other tear of lateral meniscus, current injury, right knee
  
• S83.282-, Other tear of lateral meniscus, current injury, left knee
  
• S83.289-, Other tear of lateral meniscus, current injury, unspecified knee.
  

ICD-10-CM Change: When ICD-10 hits, you will need to report the tear of meniscus current injury code based on the type of tear, which meniscus was torn, and which knee it was torn in. You do have codes for unspecified, but you should always code to the highest specificity. 

Code 836.0 expands to S83.21-, S83.22-, S83.23-, and S83.24-.

Code 836.1 expands to S83.25-, S83.26-, S83.27-, and S83.28-.

Documentation: The provider probably already specifies whether the tear is bucket-handle, other, peripheral, or complex; whether the tear occurred to the medial or lateral meniscus; and whether the tear occurred in the right or left knee. 

If the provider documents “tear of meniscus of knee NOS,” you should choose a code from the S83.20- category.

Here is how you will locate this code in your Alphabetical Index: 

Tear, torn (traumatic) — see also Laceration

- meniscus (knee) (current injury) S83.209
- - bucket-handle S83.20-
- - lateral
- - - bucket-handle S83.25-
- - - complex S83.27-
- - - peripheral S83.26-
- - - specified type NEC S83.28-
- - medial
- - - bucket-handle S83.21-
- - - complex S83.23-
- - - peripheral S83.22-
- - - specified type NEC S83.24-
- - old —see Derangement, knee, meniscus, due to old tear
- - site other than knee - code as Sprain
- - specified type NEC S83.20-

Coding tips: Each of these codes require a 7th character: A (initial encounter), D (subsequent encounter), or S (sequelae).

You will see an Excludes 1 note under S83.2 stating that you should not report this code with “old-bucket-handle tear (M23.2).” 

You will also see an Excludes 1 note under the S83 category stating that you should not report these codes with “derangement of patella (M22.0-M22.3), injury of patellar ligament (tendon)(S76.1-), internal derangement of knee (M23.-), old dislocation of knee (M24.36), pathological dislocation of knee (M24.36), and recurrent dislocation of knee (M22.0).”

You will see an Excludes 2 note under the S83 category, which means you can report “strain of muscle, fascia and tendon of lower leg (S86-)” with these codes if your physician also reports this condition.