General

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.”