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ICD-10 Guide
DiagnosesAcl Tear

Acl Tear

ICD-10 Coding for ACL Tear(S83.511A, S83.512A)

PRIMARY SPECIALTYOrthopedics
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acl Tear?
Essential facts and insights about ACL Tear

Key Clinical Considerations:

  • Presence of a popping sound at the time of injury
  • Severe pain and inability to continue activity
  • Rapid swelling after injury
  • Loss of range of motion
  • Tenderness along the joint line

Clinical Information

Clinical Criteria & Documentation Requirements

  • Detailed description of the injury event
  • Physical examination findings
  • Diagnostic imaging results confirming the ACL tear
  • Treatment plan including surgical or non-surgical interventions
  • Progress notes and follow-up evaluations

Coding Guidelines

Usage Guidelines & Examples

  • S83.511A is for right knee, initial encounter, while S83.512A is for left knee, initial encounter
  • These codes are specific for ACL tear and should not be confused with codes for other knee injuries or ligament tears

Code Exclusions

Important Exclusions

  • Chronic ACL tears
  • Other ligament injuries of the knee
  • Post-surgical ACL reconstruction

Related ICD-10 Codes

Primary Codes
S83.511A
Sprain of anterior cruciate ligament of right knee, initial encounter
S83.512A
Sprain of anterior cruciate ligament of left knee, initial encounter
Ancillary Codes
M23.51
M23.52
Differential Codes
S83.18

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Anterior cruciate ligament (ACL) tears
  • Sports injuries involving the knee
  • Accidents causing knee trauma

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Patient presented with acute knee injury, with a popping sound heard at the time of injury.

Template 2

Physical examination revealed swelling and tenderness along the joint line of the [right/left] knee.

Template 3

MRI confirmed a tear in the anterior cruciate ligament of the [right/left] knee.

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Can these codes be used for follow-up visits?

No, these codes are for initial encounters only. For subsequent visits, use the appropriate follow-up codes.

Are these codes applicable for both partial and complete ACL tears?

Yes, these codes can be used for both partial and complete ACL tears as long as it's an initial encounter.