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v1.0.0
ICD-10 Guide
ICD-10 CodesM23.0

M23.0

Billable

Cystic meniscus

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M23.0 is a billable code used to indicate a diagnosis of cystic meniscus.

Key Diagnostic Point:

Cystic meniscus refers to the presence of a cystic lesion within the meniscus of the knee, often resulting from degenerative changes or trauma. This condition can lead to internal derangements of the knee joint, including pain, swelling, and mechanical symptoms such as locking or catching. Cystic menisci are typically associated with meniscal tears, which can occur due to acute injury or chronic degeneration. The cyst may develop as a result of fluid accumulation from a tear or as a degenerative process. Diagnosis is often confirmed through imaging studies such as MRI, which can reveal the cyst's size and location, as well as any associated meniscal tears or ligament injuries. Treatment options may include conservative management, such as physical therapy and anti-inflammatory medications, or surgical intervention, including arthroscopic procedures to repair the meniscus or remove the cyst. Accurate coding for cystic meniscus is essential for proper reimbursement and to reflect the complexity of the condition and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between cystic meniscus and other meniscal injuries
  • Need for precise documentation of associated conditions
  • Variability in treatment approaches based on severity
  • Potential for co-existing ligament injuries

Audit Risk Factors

  • Inadequate documentation of the cyst's characteristics
  • Failure to document associated meniscal tears or ligament injuries
  • Misclassification of the type of meniscal injury
  • Lack of imaging reports to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments.

Common Clinical Scenarios

Patients presenting with knee pain and mechanical symptoms, often following an acute injury.

Billing Considerations

Ensure clear documentation of the cyst's size and location, as well as any associated procedures performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Patients undergoing conservative management for knee pain due to cystic meniscus.

Billing Considerations

Document functional limitations and response to therapy to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M23.0 When
  • Follow official ICD
  • CM guidelines for coding musculoskeletal disorders
  • Include documentation of the cyst's characteristics and any associated injuries
  • Ensure that the diagnosis is supported by imaging findings

Exclusion Criteria

Do NOT use M23.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, surgical; with meniscectomy

Clinical Scenario

Used when a cystic meniscus is surgically treated.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the extent of the meniscal damage.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like cystic meniscus, improving the accuracy of diagnoses and treatment documentation, which can lead to better patient care and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like cystic meniscus, improving the accuracy of diagnoses and treatment documentation, which can lead to better patient care and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of cystic meniscus?

Cystic meniscus is primarily caused by degenerative changes in the meniscus or trauma leading to meniscal tears, resulting in fluid accumulation.