Radiology Coding Alert

Prepare now for more specific knee injury coding in 2013.

ICD-10-CM is expected to replace ICD-9-CM on Oct. 1, 2013. One of the many differences you'll notice is increased options for coding lateral meniscus tears.

A lateral meniscus tear refers to tearing of the heavy cartilage (meniscus) that rests on the outside of the knee (lateral), between the thigh bone and the shin bone.

ICD-9-CM: Under ICD-9-CM 2012, you report a lateral meniscus tear using 836.1 (Tear of lateral cartilage or meniscus of knee current).

ICD-10-CM: A long list of ICD-10-CM 2012 codes cross to 836.1. Here's a condensed version:

• S83.25-A, Bucket-handle tear of lateral meniscus, current injury
• S83.26-A, Peripheral tear of lateral meniscus, current injury
• S83.27-A, Complex tear of lateral meniscus, current injury
• S83.28-A, Other tear of lateral meniscus, current injury.

The sixth digit (signified above with "-") is based on the knee documented as injured:

• 1, right knee
• 2, left knee
• 9, unspecified knee.

Coder tips: The final character ("A") denotes "initial encounter." Other seventh character options for the S83 range are "D" (subsequent encounter) and "S" (sequela). If you check the General Equivalency Mappings (GEMs) that show how ICD-9 codes cross to ICD-10, you'll see that the S83.2- codes listed above but with a final character of D (instead of A) cross to V58.89 (Other specified aftercare). If the codes ended in S, they would cross to 905.7 (Late effect of sprain and strain without tendon injury).

Documentation: The elements you'll need to see documented to help you code the injury correctly include:

• Type of lateral meniscus tear (bucket handle, peripheral, complex, other)
• Knee (right, left)
• Whether injury is current.

Remember: When ICD-10-CM goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.