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Knee/Leg

Diagnosis

Procedure

ICD10-Right

ICD10-Left

Knee
Pain
Stiffness
Sprain
Effusion
Contusion
Artificial Joint 

E/M Coding

 

Modifiers

M25.561 Pain in right knee
M25.661 Stiffness of right knee
Sprain Right knee see all
M25.461 Effusion, right knee
S80.01XA Contusion of right
Z96.651 Right artificial knee joint
Z96.653 Presence of artificial knee joint

M25.562 Pain in left knee

 

M25.662 Stiffness of left knee
Sprain Left knee see all 
M25.462 Effusion, left knee 
S80.02XA Contusion of left
Z96.652 Left artificial knee joint  

ACL Tear S83.519A M23.50

ACL Reconstruction 29888

CPT codes

S83.511A Sprain anterior cruciate ligament right knee, initial

S83.512A Sprain anterior cruciate ligament left knee, initial

Bakers Cyst M71.20

Baker's cyst Excision 27345 

CPT Codes

M71.21 - Synovial cyst of popliteal space [Baker], right knee

M71.22 - Synovial cyst of popliteal space [Baker], left knee

Chondromalacia Patella M22.40

Lateral Release 29873 

CPT Codes

M22.41 - Chondromalacia patellae, right

M22.42 - Chondromalacia patellae, left

Exertional Compartment Syndrome M79.A29

Fasciotomy Leg 27602 

CPT Codes

M79.A21 - Nontraumatic compartment syndrome of right lower extremity

M79.A22 - Nontraumatic compartment syndrome of left lower extremity

Knee Arthritis M17.10

Total Knee Arthroplasty 27447

Unicompartmental Knee Arthroplasty 27446 

CPT Codes

M17.11 - Unilateral primary osteoarthritis, right knee

Z96.651 - Presence of right artificial knee joint

M17.12 - Unilateral primary osteoarthritis, left knee

Z96.652 - Presence of left artificial knee joint

Knee Contracture M24.569

 

M24.561 - Contracture, right knee

M24.562 - Contracture, left knee

LCL Tear S83.429A

LCL Repair 27427 

CPT Codes

S83.421A - Sprain of lateral collateral ligament of right knee, initial encounter

S83.422A - Sprain of lateral collateral ligament of left knee, initial encounter

MCL Tear S83.419A

MCL Repair 27405 

CPT Codes

S83.411A - Sprain of medial collateral ligament of right knee, initial encounter

S83.412A - Sprain of medial collateral ligament of left knee, initial encounter

Meniscal Tear S83.209A

Meniscal Repair 29882 

CPT Codes

S83.206A - Unspecified tear of unspecified meniscus, current injury, right knee, initial encounter

Current Injury Codes  

No or Old Injury Meniscus Codes

S83.207A - Unspecified tear of unspecified meniscus, current injury, left knee, initial encounter

Current Injury Codes 

No or Old Injury Meniscus Codes

Meniscal Tear-LATERAL  S83.279A

Knee Arthroscopy with Partial Meniscectomy 29881

 CPT Codes

S83.271A - Complex tear of lateral meniscus, current injury, right knee, initial encounter

Current Injury Codes  

No or Old Injury Codes
M23.251 Derangement of posterior horn of lateral meniscus 

S83.272A - Complex tear of lateral meniscus, current injury, left knee, initial encounter
Current Injury Codes 
No or Old Injury Codes
M23.252 Derangement of posterior horn of lateral meniscus 

Meniscal Tear-MEDIAL S83.239A

Knee Arthroscopy with Partial Meniscectomy 29881 

CPT Codes

S83.231A - Complex tear of medial meniscus, current injury, right knee, initial encounter

Current Injury Codes 

No or Old Injury Codes
M23.221 Derangement of posterior horn of medial meniscus 

S83.232A - Complex tear of medial meniscus, current injury, left knee, initial encounter
Current Injury Medial Codes
 

No or Old Medial Codes
M23.222 Derangement of posterior horn of medial meniscus

Patella Fracture S82.009A

Patella Fracture ORIF 27524 

CPT Codes

S82.031A - Displaced transverse fracture of right patella, initial encounter for closed fracture

See ALL

S82.032A - Displaced transverse fracture of left patella, initial encounter for closed fracture

See ALL

Patellar Dislocation S83.006A

MPFL Reconstruction 27420 

CPT Codes

S83.014A - Lateral dislocation of right patella, initial encounter

See ALL

S83.015A - Lateral dislocation of left patella, initial encounter
See ALL

Patellar Tendon Rupture M66.269

Patellar Tendon repair 27380

See all Infrapatellar CPT codes

S86.811A - Strain of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter

S86.821A - Laceration of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter

S86.812A - Strain of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter

S86.822A - Laceration of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter

Patellar Tendonitis M76.50

 

M76.51 - Patellar tendinitis, right knee

M76.52 - Patellar tendinitis, left knee

Patellofemoral Arthritis M17.10

Patellofemoral Replacement 27438 

CPT Codes

M17.11 - Unilateral primary osteoarthritis, right knee

M17.12 - Unilateral primary osteoarthritis, left knee

PCL Tear S83.529A, M23.629

PCL Reconstruction 29889 

CPT Codes

S83.521A - Sprain of posterior cruciate ligament of right knee, initial encounter

S83.522A - Sprain of posterior cruciate ligament of left knee, initial encounter

Plica Syndrome M67.50

Knee arthroscopy with synovectomy, limited 29875 

CPT Codes

M67.51 - Plica syndrome, right knee

M67.52 - Plica syndrome, left knee

Prepatellar Bursitis M70.40 726.65

EXCISION, PREPATELLAR BURSA 27340 

CPT Codes

M70.41 Prepatellar bursitis, right knee

M70.42 Prepatellar bursitis, left knee

Quadriceps Tendon Rupture S76.119A

Quadriceps Tendon Repair 27385

CPT Codes

S76.111A - Strain of right quadriceps muscle, fascia and tendon, initial encounter
See ALL

S76.112A - Strain of left quadriceps muscle, fascia and tendon, initial encounter
See ALL

Tibial Plateau Fracture S82.109A

Tibial Plateau Fracture ORIF 27535 

CPT Codes

S82.121A-Displaced fracture of lateral condyle of right tibia, initial encounter for closed fracture

S82.124A-Nondisplaced fracture of lateral condyle of right tibia, initial encounter for closed fracture

S82.131A-Displaced fracture of medial condyle of right tibia, initial encounter for closed fracture

S82.134A-Nondisplaced fracture of medial condyle of right tibia, initial encounter for closed fracture

S82.141A-Displaced bicondylar fracture of right tibia, initial encounter for closed fracture

S82.144A-Nondisplaced bicondylar fracture of right tibia, initial encounter for closed fracture

S82.122A-Displaced fracture of lateral condyle of left tibia, initial encounter for closed fracture

S82.125A-Nondisplaced fracture of lateral condyle of left tibia, initial encounter for closed fracture

S82.132A-Displaced fracture of medial condyle of left tibia, initial encounter for closed fracture

S82.135A-Nondisplaced fracture of medial condyle of left tibia, initial encounter for closed fracture

S82.142A-Displaced bicondylar fracture of left tibia, initial encounter for closed fracture

S82.145A-Nondisplaced bicondylar fracture of left tibia, initial encounter for closed fracture

Tibial Shaft Fracture S82.209A

Tibial Shaft Fracture IM Nail 27759 

Tibial Shaft Fracture External Fixation 20690 

CPT Codes

S82.231A - Displaced oblique fracture of shaft of right tibia, initial encounter for closed fracture

See ALL

S82.232A - Displaced oblique fracture of shaft of left tibia, initial encounter for closed fracture
See ALL

Tibial Shaft Stress Fracture M84.369A

Tibial Shaft Fracture IM Nail 27759 

CPT Codes

M84.361A - Stress fracture, right tibia, initial encounter for fracture

M84.362A - Stress fracture, left tibia, initial encounter for fracture

 

 

see 7th Character Coding

A=initial encounter, D=subsequent encounter,