Knee¶
Return to Table of Contents¶
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
**
Articular Cartilage¶
· 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
- Use the 836.2 series of codes to cover a chondral injury or chondral lesion; can also Freeform search on ‘cartilage injury’
and use the 836.2.L or 836.2.R codes
· Chondroplasty is a commonly used procedure for this injury
· Freeform on ‘chondroplasty knee’ returns codes described as ‘Other repair or plastic operations on bone’ , but a chondroplasty generally consists of smoothing the articular surface or articular cartilage of the knee by using a mechanized shaver which removes loose fragments of cartilage and leaves a smooth surface
· 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
· If the procedure performed is smoothing cartilage , use the "Division of joint capsule ligament or cartilage"; the root code for the treatment is 80.4
· If bone was involved, then use the ‘Other repair or plastic operations code’ , with the root code of 78.4
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 codes described as ‘Knee-other tear of cartilage or meniscus’. These codes are 836.2.L/R
Cruciate Ligaments¶
- A Cruciate Ligament injury is not broken down in the system as to 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 system root code 844.2
-
If the repair involves reconstruction of the ligament using a tendon graft, and the tendon used for the graft is taken from the claimant , the excision of the tendon is coded as a separate procedure
-
83.41 series of codes with description of ''Excision of tendon for graft' are the treatment codes to use
¶
Debridement of Meniscus¶
· For the purpose of the system, the treatment code ’80.6.L/R Excision of Semilunar cartilage of knee ’ (meniscectomy, removal of medial or lateral meniscus or both menisci) covers debridement of meniscus
Meniscus (semi-lunar cartilage) { #Meniscus(semi-lunar_cartilage\ }¶
· Meniscus injuries may be described as anterior horn , posterior horn , and bucket handle tear, though 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
· Root code of medial 836.0
· Root code of lateral 836.1
Meniscectomy¶
· A meniscectomy is the excision of the semi-lunar cartilage, and covers both a partial and total meniscectomy and the debridement of the meniscus
· If a meniscectomy is preformed with a medial collateral repair , then enter the Five-in-One Knee Repair , 81.42.L/R
· If a meniscectomy is performed with an anterior cruciate ligament and medial collateral ligament repair , then enter Triad Knee Repair, 81.43
- The root code for meniscectomy is 80.6
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 732.7.GL/GR
· The Medical Library text in the system provides a detailed explanation/definition of Osteochondritis Dissecans
Partial Meniscectomy¶
· For the purpose of the system, the treatment code ‘80.6.L/R ‘Excision of Semilunar cartilage of knee’ (meniscectomy, removal of medial or lateral meniscus or both menisci) is used for a partial meniscectomy’
Patella¶
- A patella subluxation is an incomplete dislocation of the knee cap and is found using the Freeform search ‘patella dislocation’
- An incomplete dislocation, or subluxation, is generally treated conservatively; whereas a complete dislocation often requires reduction and/or other operative measures
Patellectomy¶
· Refers to the 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 partial patellectomy is ’77.86.L/R Other partial ostectomleft/right patella’
· The code in the system for a total patellectomy is ’77.96.L/R – Total ostectomleft/right patella’ (Patellectomy)
Patelloplasty¶
· This is entered in the system using ‘78.46.L/R – Other repair or plastic operations on bonleft/right patella’
Plica¶
· The Plica is a part of the knee joint that is 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 80.7
· 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 ‘83.13.E3L/R - Other tenotomy-left/right knee’
· 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 in addition to the synovectomy
· The system root code 80.76
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 | 836.0.L/R or 836.1.L/R |
|---|---|
| Chondral Injury/Chondral Lesion/Chondral Defect | 836.2.L/R |
| Loose Body in Knee | 717.6.L/R |
| Dislocation/Subluxation of Patella--(Partial or Complete) | 836.3.L/R (closed) -- 836.4.L/R (open) |
| Anterior Cruciate Ligament (ACL) | |
| Sprain/Tear/Rupture | |
| Posterior Cruciate Ligament (PCL) | |
| Sprain/Tear/Rupture | |
| Minor | 844.2.AL/AR |
| Moderate | 844.2.BL/BR |
| Severe | 844.2.CL/CR |
| Medial Collateral Ligament (MCL) Sprain/Tear/Rupture | |
| Minor | 844.1.AL/AR |
| Moderate | 844.1.BL/BR |
| Severe | 844.1.CL/CR |
| Lateral Collateral Ligament (LCL) Sprain/Tear/Rupture | |
| Minor | 844.0.AL/AR |
| Moderate | 844.0.BL/BR |
| Severe | 844.0.CL/CR |
| Quadriceps/Patella Tendon Sprain/Strain | |
| Minor | 844.8.A1L/A1R |
| Moderate | 844.8.A2L/A2R |
| Severe Patellectomy Partial patellectomy/partial ostectomy-patella Total patellectomy/total ostectomy-patella | 844.8.A3L/A3R 77.86.L/R 77.96.L/R |
Complications¶
| Chondromalacia | 717.7.AL/AR |
|---|---|
| Synovitis/Tenosynovitis | 727.00.DL/DR |
| Osteochondritis Dissecans (OCD)/Osteochondral Defect | 732.7.GL/GR |
| Popliteal Cyst/Baker's Cyst | 727.51.AL/AR |
Treatments¶
| Arthroscopy | 80.26.L/R |
|---|---|
| Meniscectomy (Partial or Complete) / Excision of Semi-lunar | |
| Cartilage | 80.6.L/R |
| Debridement of Meniscus | 80.6.L/R |
| Chondroplasty/Surgery of Articular Cartilage | 80.46.L/R |
| Cruciate Ligament Repair | 81.45.L/R |
| Collateral Ligament Repair | 81.46.L/R |
| Synovectomy/Excision of Plica/Plicaectomy | 80.76.L/R |
| Triad Knee Repair (Repair of ACL,MCL & Meniscectomy) | 81.43.L/R |
| Five-In-One Knee Repair (Repair of MCL & Meniscectomy) | 81.42.L/R |
| Tendon Graft | 83.81.E3L/E3R |
| Excision of Tendon for Graft | 83.41.E3L/E3R |
| Retinacular Release/Lateral Retinacular Release | 83.13.E3L/R |
| Patellar Stabilization/Roux-Goldthwait Procedure | 81.44.L/R |
Pre-Existing Conditions¶
| Chondromalacia | 717.7 BL/BR |
|---|---|
| Osteoarthritis | 715.16.AL/BL/CL 715.16/AR/BR/CR |
| Popliteal Cyst | 727.51.BL/BR |