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ICD-10 Guide
ICD-10 CodesM23.00

M23.00

Billable

Cystic meniscus, unspecified meniscus

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

Code Description

ICD-10 M23.00 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified meniscus.

Key Diagnostic Point:

Cystic meniscus refers to the presence of a cystic lesion within the meniscus of the knee, which can arise from various underlying conditions, including degenerative changes or meniscal tears. The meniscus is a C-shaped cartilage that acts as a cushion between the femur and tibia, and its integrity is crucial for knee stability and function. Cystic changes can lead to internal derangements, causing pain, swelling, and limited range of motion. Patients may present with symptoms such as joint locking or clicking, which can indicate a meniscal tear. Diagnosis typically involves imaging studies, such as MRI, which can reveal the presence of cysts and associated meniscal tears. Treatment options may include conservative management, such as physical therapy and anti-inflammatory medications, or surgical interventions like arthroscopy to repair or remove the damaged meniscus. Accurate coding of cystic meniscus is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of cystic meniscus
  • Differentiation from other meniscal injuries and conditions
  • Need for precise documentation of imaging findings
  • Potential for concurrent ligament injuries complicating the diagnosis

Audit Risk Factors

  • Inadequate documentation of imaging results
  • Failure to specify the type of meniscal injury
  • Misclassification of cystic changes as other knee conditions
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are essential for accurate coding.

Common Clinical Scenarios

Patients presenting with knee pain and swelling, often after an injury, requiring surgical intervention.

Billing Considerations

Documentation must clearly outline the nature of the cystic changes and any associated meniscal tears or ligament injuries.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes are necessary to support the diagnosis.

Common Clinical Scenarios

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

Billing Considerations

Focus on functional limitations and response to therapy is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M23.00 When
  • According to ICD
  • 10 guidelines, M23
  • 00 should be used when the cystic meniscus is confirmed but not specified further
  • Coders should ensure that the diagnosis is supported by imaging and clinical findings

Exclusion Criteria

Do NOT use M23.00 When
  • Exclusion criteria include conditions that are not related to the meniscus or knee joint

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, surgical; with meniscectomy, medial or lateral meniscus

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 specific meniscal pathology addressed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of knee conditions, including cystic meniscus. This specificity aids in better tracking of treatment outcomes and resource allocation in healthcare settings.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of knee conditions, including cystic meniscus. This specificity aids in better tracking of treatment outcomes and resource allocation in healthcare settings.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of knee conditions, including cystic meniscus. This specificity aids in better tracking of treatment outcomes and resource allocation in healthcare settings.

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 can result from degenerative changes, trauma, or as a complication of meniscal tears, leading to fluid accumulation within the meniscus.