Knee¶
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The Knee
Articular Cartilage/Chondroplasty
Chondral Defect/Chondral Injury/Chondral Lesion
Osteochondral Defect/Osteochondral Lesion/Osteochondritis Dissecans
Resection of medial shelf in the knee
Common Knee Medical Codes and Descriptions
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Articular Cartilage¶
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A chondral injury or lesion , is another common injury to the knee’s articular cartilage and is generally caused by the twisting of, or a direct blow to, the knee; it is often seen in conjunction with other knee injuries such as ACL injuries
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Use the S83.20 series of codes to cover a chondral injury or chondral lesion; can also Free Form Search on ‘cartilage injury’ and use S83.203A.G (right) S83.204A.G (left)
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Chondroplasty is a commonly used procedure for this injury
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Many times the pre and post operative procedures on the operative report will state chondroplasty; read the operative report to determine the correct procedure as it generally involves smoothing the cartilage and not surgery on the bone
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If the procedure performed is smoothing cartilage, use the code described as "Division of Knee Bursa and Ligament- division of joint capsule, ligament or cartilage"; the root code for the treatment is 0M8N (right) and 0M8P (left)
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If bone was involved, then use the ‘Other repair or plastic operations code’, with the root code 0QQD (right) or 0QQF (left)
Chondral Defect/Chondral Injury/Chondral Lesion¶
· These are injuries to the articular cartilage of the knee
· In the system this is captured by using the code described as ‘Other tear of meniscus, current injury, knee'. The codes are S83.203A.G or S83.204A.G
Cruciate Ligaments¶
- A Cruciate Ligament injury is not broken down as to the Posterior or Anterior Cruciate Ligament , it is referred to only as the cruciate ligament; if there is a tear of both the ACL and PCL, then the code will be entered twice to account for each ligament
- The root code is S83.501 (right) and S83.502 (left)
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Debridement of Meniscus
For the purpose of the system, the treatment code described as 'Excision of Semilunar cartilage of knee (meniscectomy, removal of medial or lateral meniscus or
both menisci)' covers debridement of meniscus; the root codes are 0SBD (left) and 0SBC (right)
Meniscectomy
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A meniscectomy is the excision of the semi-lunar cartilage, and covers both a partial and total meniscectomy and the debridement of the meniscus. The root codes are 0SBD/0SBC; the codes are described as 'Excision of semilunar cartilage of knee (meniscectomy, removal of medial or lateral meniscus or both menisci)'
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If a meniscectomy is performed with a medial collateral repair , then enter the root code for Five-in-One Knee Repair: 0MQP/ 0MQN (Repair Knee Bursa and Ligament, Five-in-one repair)
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If a meniscectomy is performed with an anterior cruciate ligament and medial collateral ligament repair , then enter Triad Knee Repair; root codes are 0MQP/0MQN and are described as 'Repair Knee Bursa and Ligament (Triad knee repair)
Meniscus Injury (semi-lunar cartilage) { #Meniscus(semi-lunar_cartilage\ }¶
· Meniscus injuries can be described as anterior horn, posterior horn, and bucket handle tear or complex/partial tear; the system does not distinguish between the types of tears; all that is required is to know if the tear occurred to the medial or lateral meniscus
· Freeform search on knee meniscus for injury codes
· The root codes covering medial or lateral are S83.242A/S83.241A (left/right) and S83.282A/S83.281A (left/right)
Osteochondral Defect/Osteochondral Lesion¶
· The above are synonymous with Osteochondritis Dissecans
· Osteochondral Defect/Osteochondral and Lesion/Osteochondritis Dissecans are considered a complication in the system
· The complication involves bone and cartilage
· The medical code in the system is M93.261 (right) or M93.262 (left)
· The Medical Library text in the system provides a detailed explanation/definition of Osteochondritis Dissecans
Patella¶
- A patella subluxation is an incomplete dislocation of the knee cap and is found using the Freeform search ‘patella dislocation’; the codes are described as 'Dislocation knee-patella' and are broken down further to include if the dislocation was closed or open
- An incomplete dislocation, or subluxation, is generally treated conservatively; whereas a complete dislocation often requires reduction and/or other operative measures
Patellectomy¶
· Refers to partial or total removal of the patella
· In the system, the codes used to cover this procedure are referred to as an ostectomy of the patella
· The code in the system for a total patellectomy is ‘Resection of patella- total ostectomy (patellectomy)’; the root codes are 0QTD (right) and 0QTF (left)
· The code in the system for a partial removal of the patella is described as 'Excision of Patella- other partial ostectomy'; the root codes are 0QBF (left) and 0QBD (right)
Patelloplasty¶
· This is entered in the system using ‘Repair patella (Other repair or plastic operations on bone)'
· Root code 0QQD is for right patella and 0QQF is for left patella
Plica¶
· The Plica is a part of the knee joint and is actually a fold in the synovial lining/tissue of the knee; there are a total of four plica synovial folds in the knee, but generally the medial plica is the one that causes the most problems mainly due to its location and attachments
· The removal or excision of the plica may also be referred to as a plicaectomy
· Excision of the Plica is another common knee procedure; in the system excision of the plica is covered by using the treatment Synovectomy of the knee
· This treatment can be located via freeform search using the key words ‘synovectomy knee’. On the Medical Model, it can be found under the Treatment type/category of ‘Operations on joints’
· The root code is 0SBC (right) or 0SBD (left)
· When diagnosed, Synovitis is entered as a complication
Resection of medial shelf in the knee¶
· This is entered in the system as a synovectomy
Retinacular Release¶
· The retinaculum is a band or band-like structure that holds an organ or tissue in place
· The retinaculum of the knee is a ligament complex which anchors the outer edge of the patella and helps hold the patella in place
· A retinacular release is typically done to correct problems with the patella and involves cutting or 'releasing' the ligaments
· The code in the system to use for a retinacular release is ‘Division of knee tendon (Other tenotomy)'
· The root code is 0L8Q (right) and 0L8R (left)
· Tenotomy implies 'tendon release' and the retinacular release relates to ligaments it is still appropriate to use the tenotomy code for the retinacular release.
· Tendons and ligaments are similar structures and for the purpose of the system we use the terms together and interchangeably, much like we use the terms sprain and strain together
Synovectomy¶
· Also known as:
· Resection of medial shelf in the knee
· Plicaectomy
· Excision of the Plica
· Synovectomy is the partial or complete surgical removal of a synovial membrane of a joint
· If it is performed arthroscopically enter the arthroscopy
· The system root code 0SBC (right) and 0SBD (left)
Unicondylar arthroplasty¶
· This is a partial knee replacement
· The system does not currently have a code for a partial knee replacement
MEDICAL CODES¶
Injuries¶
| Meniscus Tear/Semi-lunar Cartilage Tear/Rupture | S83.22 |
|---|---|
| Chondral Injury/Chondral Lesion/Chondral Defect | S83.203A/S83.204A |
| Loose Body in Knee | M23.4 |
| Dislocation/Subluxation of Patella--(Partial or Complete) | S83.0 |
| Anterior Cruciate Ligament (ACL) | S83.501/S83.502 |
| Sprain/Tear/Rupture | |
| Posterior Cruciate Ligament (PCL) | S83.501/S83.502 |
| Sprain/Tear/Rupture | |
| Medial Collateral Ligament (MCL) Sprain/Tear/Rupture | S83.41 |
| Lateral Collateral Ligament (LCL) Sprain/Tear/Rupture | S83.42 |
| Quadriceps/Patella Tendon Sprain/Strain | S76.11 |
Complications¶
| Chondromalacia | M22.4 |
|---|---|
| Synovitis/Tenosynovitis | M65.88.D |
| Osteochondritis Dissecans (OCD)/Osteochondral Defect | M93.26 |
| Popliteal Cyst/Baker's Cyst | M71.2 |
Treatments¶
| Arthroscopy | 0SJD4/0SJC4 |
|---|---|
| Chondroplasty/Surgery of Articular Cartilage | 0SND/0SNC |
| Cruciate Ligament Repair | 0M8N/0M8P |
| Collateral Ligament Repair Meniscectomy (Partial or Complete)/Excision of Semi-lunar Cartilage Debridement of Meniscus Partial patellectomy/partial ostectomy-patella | |
| Total patellectomy/total ostectomy-patella | 0MQP/0MQN 0SBD/0SBC 0SBD/0SBC 0QBD/0QBF 0QTD/0QTF |
| Synovectomy/Excision of Plica/Plicaectomy | 0SBD/0SBC |
| Tendon Graft Excision of Tendon for Graft | 0LUR/0LUQ 0LBR0ZZ.A/0LBQ0ZZ.A |
| Retinacular Release/Lateral Retinacular Release | 0L8R0ZZ.D/0L8Q0ZZ.D |
| Patellar Stabilization/roux-Goldthwait Procedure (Reposition Patella) | 0QSF/0QSD |
Pre-Existing Conditions¶
| Chondromalacia | M22.4 |
|---|---|
| Osteoarthritis | M17.1 |
| Popliteal Cyst | M71.2 |