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old vs new meniscus tears

  1. Default old vs new meniscus tears
    Medical Coding Books
    Can anybody explain the difference between 836.0/836.1 (current tears) and 717.2/717.43 (old derangement of meniscus). Is there a time frame that changes the dx code to an old tear?

  2. #2
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    I was always taught that you always code current tear (836.0/836.1) unless the surgeon specifically states that it is a degenerative tear(717.X series).

    I had a real hard time doing this for many years and argued and argued, and was noncompliant with what I had learned because I didnt want to give the patient an "injury" diagnosis...then one day....I was DINGED in an audit!!

    The example given was basically stating that if you always code degenerative, you are giving the patient a dx/disease they may or may not have.


    Hope this helps,
    Mary, CPC, COSC

  3. #3
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    Thanks for the clarification on that....been using the 717.x for anesthesia coding and HATED it!!!

  4. Default
    Thanks Mary for the input. I was taught the same way (always code current unless degenerative is specified) and was doing this until the ASC we work out of started requesting our op notes for their billing purposes and they are now telling me that if the doc states in the op note that the patient had, for example, a "tear of the posterior horn of the medial meniscus", the ASC is telling me we should code 717.2. Is that correct? The op note or any of the previous office visit notes state that this is an old injury. Thanks.


    Ann Marie, CPC

  5. Default
    I just had an op note and in H&P notes indicated DOI 8/2008 from a fall (9 months ago) and still coded 836.1 for the lateral tear.

  6. #6
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    I believe your ASC is incorrect. That is not the correct way to code it.
    Last edited by mbort; 05-28-2009 at 01:12 PM. Reason: typo

  7. #7
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    I see what you are saying Mary - but I am wondering, I use the 836 series codes when it is a recent injury. But when it comes to an injury that occurred say 2 years ago I am using the 717.X series. Are you saying that you would still use the injury codes?
    Crystal, CPC, CCS-P

  8. #8
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    Quote Originally Posted by CrysLednum View Post
    I see what you are saying Mary - but I am wondering, I use the 836 series codes when it is a recent injury. But when it comes to an injury that occurred say 2 years ago I am using the 717.X series. Are you saying that you would still use the injury codes?
    If the note specifically states that the injury occurred 2 years ago then you would be ok or if the note specifically states that its a degenerative tear.

    I do surgical coding so this is RARELY documented in an operative note therefore 98% of the time I am stuck using the 836.X series

    Mary, CPC, COSC

  9. #9
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    Got it thanks!
    Crystal, CPC, CCS-P

  10. #10
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    So ladies - where does one find the definition of old vs current injury? I have a PA telling me if it's more than 2 weeks since the injury it is 717.XX. The note states that the onset of pain was 3 months ago while playing hockey. Thoughts?
    Lisa Bledsoe, CPC, CPMA

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