icd 9 code for degeneration meniscus

Full Answer

What is the ICD 9 code for meniscus?

Short description: Derangement meniscus NEC. ICD-9-CM 717.5 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 717.5 should only be used for claims with a date of service on or before September 30, 2015.

What is the ICD 9 code for derangement of lateral meniscus?

Derangement of lateral meniscus, unspecified Short description: Derang lat meniscus NOS. ICD-9-CM 717.40 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 717.40 should only be used for claims with a date of service on or before September 30, 2015.

What is meniscal degeneration of the meniscus?

Of the multitude of etiologies for knee pain, meniscal degeneration plays a significant role. The meniscus degenerates microscopically and macroscopically with the aging process, resulting in pain and knee dysfunction.

Is arthroscopic partial meniscectomy necessary for degenerative meniscus?

CONCLUSION The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology.

What is the ICD 9 code for meniscus tear?

ICD-9 Code 836.0 -Tear of medial cartilage or meniscus of knee current- Codify by AAPC.

How do you code a meniscus tear?

Tear of meniscus, current injury S83. 2-

What causes meniscus to fray?

These tears of the menisci are commonly seen as a part of the overall condition of osteoarthritis of the knee in aging adults. Degenerative tears cause the menisci to fray and become torn in many directions.

What is the ICD 10 code for knee derangement?

Unspecified internal derangement of unspecified knee M23. 90 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M23. 90 became effective on October 1, 2021.

What is the ICD 10 code for meniscus tear left knee?

242A for Other tear of medial meniscus, current injury, left knee, initial encounter is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .

What is the correct ICD-10-CM code for the torn meniscus?

Tear of meniscus, current injury ICD-10-CM S83. 241A is grouped within Diagnostic Related Group(s) (MS-DRG v39.0):

What are 3 signs of a meniscus tear in the knee?

SymptomsA popping sensation.Swelling or stiffness.Pain, especially when twisting or rotating your knee.Difficulty straightening your knee fully.Feeling as though your knee is locked in place when you try to move it.Feeling of your knee giving way.

What is fraying of the medial meniscus?

Meniscal fraying is a term given to an irregular edge of the meniscus (often of the thinner inner edge) without discrete tearing.

What is a shredded meniscus?

It's a piece of cartilage in your knee that cushions and stabilizes the joint. It protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.

What is internal derangement of the knee?

Internal derangement of the knee is a mechanical disorder of the knee which interferes with normal joint motion and/or mobility. A fragment of soft tissue or bone that suddenly becomes interposed between the articular surfaces is the classic cause of internal derangement.

What is unspecified internal derangement of left knee?

Internal derangement of the knee (IDK) is a chronic condition that interferes with normal knee joint function. Several things can cause it, such as injured ligaments, loose pieces of bone or cartilage in the knee joint, or a torn meniscus. Over time, it can cause pain, instability, and limited knee flexibility.

What is the ICD-10 code for internal derangement of left knee?

ICD-10 Code for Unspecified internal derangement of left knee- M23. 92- Codify by AAPC.

What are the signs of a meniscus injury?

Several findings are suggestive of meniscus injury including joint line tenderness, positive McMurray’s test, locking, and palpable or audible clicking. The examiner should also examine the contralateral knee for comparison. Initial visual inspection of the knee should investigate for evidence of infection or trauma, such as erythema, wound, ecchymosis, or gross deformity. Patients with degenerative meniscus pathology rarely present with joint effusion, unlike after acute meniscus or ligamentous injury. Range of motion may be decreased due to a physical block caused by displaced meniscal material. Most often, passive and active range of motion is full and equivalent to the contralateral knee. With range of motion, clicking may be heard or felt; this is suggestive of meniscal pathology, although osteoarthritis, patella-femoral syndrome, and loose bodies also cause this sign. Joint line tenderness and a positive McMurray test are described as highly suggestive of meniscus injury, though study results vary regarding their sensitivity and specificity. Joint line tenderness sensitivity ranges from 63%-87%, while specificity ranges from 30%-50%[22,23]. A positive McMurray test has a sensitivity of 32%-34% and specificity of 78%-86%[22,23]. Ercin et al[24] found physical examination by an experienced practitioner to have better specificity (90% vs60%), positive predictive value (95% vs83%), negative predictive value (90% vs86%), and diagnostic accuracy (93% vs83%) than MRI for medial meniscal tears. They assert that physical examination is sufficient to diagnose a meniscus tear and proceed with arthroscopy. Currently, however, most surgeons choose to obtain advanced imaging prior to arthroscopy.

What is the treatment for a degenerative meniscal tear?

Conservative and surgical modalities can be utilized in the treatment of the painful degenerative meniscal tear. No matter the method, the ultimate goal remains the same: to relieve acute symptomology and limit future recurrence. Nonoperative therapy is often times the mainstay of treatment, while surgical procedures are reserved for patients with symptoms resistant or recurrent to conservative management.

What is a meniscal tear?

Meniscal tears can be classified as acute or degenerative. Acute tears are from excessive force applied to a normal knee and meniscus. This is different from a degenerative tear, which results from repetitive normal forces acting upon a worn down meniscus. Tears can also be described based on pattern and location. These tear patterns include vertical longitudinal, oblique, transverse (radial), horizontal, meniscal root, bucket-handle, and complex. Tears can located in the avascular or vascular zone (i.e., white, red-white, red-red), which influences healing potential either spontaneously or after surgical repair[13]. Degenerative tears generally have a complex tear pattern and are predominantly found in the posterior horn and midbody[14]. Previous studies have shown an increase in articular cartilage changes in the presence of degenerative meniscal tears[15,16]. In 44 patients, Mesiha et al[17] showed that degenerative meniscal tears were associated with the presence of Outerbridge II chondral degeneration more than 85% of the time, compared to 12% for flap tears and 0% for longitudinal tears. Likewise, in a prospective study of 497 consecutive knee arthroscopies in patients with meniscus tears, Christoforakis et al[18] found that patients with complex or horizontal tears were significantly more likely to have Outerbridge types III and IV chondral lesions. Additionally, patients with complex tears were significantly more likely to have a second chondral lesion than patients with flap, radial, or bucket handle tears. The literature; however, is not conclusive. In a multicenter cohort study, Badlani et al[19] showed that the rate of medial meniscus degenerative tear was not significantly higher in those who developed osteoarthritis. However, meniscal extrusion and tears with a large radial involvement were, in fact, significantly associated with osteoarthritis. Osteoarthritis and degenerative meniscal tears share many of the same risk factors and biological processes. Therefore, it is difficult to definitively determine if one condition precedes the other, or if they both occur independently and/or simultaneously.

What is the purpose of the menisci?

The menisci are essential for joint stability, shock absorption, distribution of contact forces, joint lubrication, and proprioception [1]. The medial meniscus is C-shaped, approximately 3 cm wide, and 4 to 5 cm long[2]. The posterior horn is larger than the anterior horn and various studies have described the different bony attachments. The anterior horn of the medial meniscus generally has a firm, bony attachment. Studies have shown that 3%-14% of medial menisci have no bony attachment for the anterior horn[3,4]. The insertion of the posterior horn lies anterior to the posterior cruciate ligament. The capsular attachments of the medial meniscus onto the tibia are known as the coronary ligaments, with a thickening along the midportion referred to as the deep medial collateral ligament[5].

What percentage of meniscus is water?

Water makes up approximately 70%-75% of the normal meniscus[8]. The dry weight is comprised of collagen (60%-70%), noncollagenous proteins such elastin (8%-13%), and proteoglycans (1%). The majority of collagen is type 1 (90%) with type II, III, V, and VI making up smaller amounts[8,9]. The orientation of collagen fibers is predominantly circumferential. A smaller amount of radially oriented fibers are located at the surface. In addition, a collagen fibrillar network organized into a mesh like matrix is at the surface to aid in distribution of shear forces[8,9].

What is the size of the lateral meniscus?

It is approximately 3 cm wide and 3 to 4 cm in length [2]. The lateral meniscus is anchored anteriorly and posteriorly; however, the capsular attachment is not as well developed as the medial side. As a result, there is increased translation and movement of the lateral meniscus throughout all ranges of motion[6]. The anterior horn inserts just adjacent to the anterior cruciate ligament. The posterior horn inserts behind the intercondylar eminence, anterior to the insertion site of the posterior horn of the medial meniscus. The posterior horn also has meniscofemoral ligaments known as the ligament of Humphries and ligament of Wrisberg, which connect posterior horn to the lateral aspect of the medial femoral condyle[7].

Which type of cell is most abundant in the meniscus?

Fibrochondrocytes are the predominant cell type in the meniscus, producing collagen and its extracellular matrix[8,9]. Along the inner avascular zone, cells are morphologically similar to articular chondrocytes; on the periphery, cells are more similar to fibroblasts. Arnoczky et al[10] demonstrated that the outer 10% to 30% of the medial meniscus and 10% to 25% of the lateral meniscus is vascular. The medial and lateral geniculate arteries form a perimeniscal capillary plexus the supplies the outer surface of the menisci. The menisci have intrinsic innervation, which is most abundant on the periphery and the anterior and posterior horns[9]. Proprioception is believed to be obtained from free nerve endings that are activated on the anterior and posterior horns during flexion and extension of the knee[11,12].

What is the code for current tear?

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).

What is internal derangement of the knee?

Internal derangement of the knee is a mechanical disorder of the knee which interferes with normal joint motion and/or mobility. A fragment of soft tissue or bone that suddenly becomes interposed between the articular surfaces is the classic cause of internal derangement. The misplaced fragment can be radiolucent or radiopaque. The most frequent cause of locking is entrapment of the radiolucent meniscus.

Do you have to use chronic injury codes?

In this situation, you probably have to use chronic injury-related codes unless the provider says otherwise.

Is it ok to write a note that says a degenerative tear?

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.