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v1.0.0
ICD-10 Guide
DiagnosesRight Knee Acl Tear

Right Knee Acl Tear

ICD-10 Coding for Right Knee ACL Tear(S83.511A, M23.511)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Acute knee pain and swelling
  • Positive Lachman test or anterior drawer test
  • Limited range of motion and instability during physical examination

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including mechanism of injury
  • Physical examination findings and diagnostic imaging results
  • Use of specific terms like 'complete tear' or 'partial tear'

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding based on the type of tear and encounter.
  • Common errors include misclassifying the severity of the tear.

Code Exclusions

Important Exclusions

  • Other knee ligament injuries
  • Previous knee surgeries affecting the ACL

Related ICD-10 Codes

Primary Codes
S83.511A
Complete tear of anterior cruciate ligament of right knee, initial encounter
S83.512A
Partial tear of anterior cruciate ligament of right knee, initial encounter
Ancillary Codes
Y93.64
Differential Codes
M23.511
S83.511A

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Athletes and active individuals
  • Orthopedic clinics and sports medicine facilities

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

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

What are the documentation requirements?

Include detailed patient history, physical exam findings, and imaging results.

What are the billing considerations?

Ensure accurate coding based on the severity of the tear and initial encounter status.