General Question for the Week of January 11, 2021

General Compliance Question of the Week

Question:

I am trying to find a diagnosis code for chronic anterior cruciate ligament tear of the right knee. The clinical history is knee pain, evaluate meniscus and cartilage with history of recurrent patella subluxation. If I go to tear ligament it directs you to sprain. Sprain cruciate ligament, anterior is S83.511, which doesn’t seem right because this isn’t a current tear. Any suggestions?

Answer:

Unless there is a specific code for “chronic,” Coding Clinic says to code as a current injury: It notes in answers to different questions regarding chronic or degenerative tears that although not usually described that way in the medical record, chronic or degenerative tears/strain, etc. are “usually the result of repetitive trauma.”

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.