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ICD-10 Guide
ICD-10 CodesM23.005

M23.005

Billable

Cystic meniscus, unspecified medial meniscus, unspecified knee

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

Code Description

ICD-10 M23.005 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified medial meniscus, unspecified knee.

Key Diagnostic Point:

Cystic meniscus refers to the presence of a cystic lesion within the meniscus of the knee, specifically affecting the medial meniscus. This condition is often associated with internal derangements of the knee joint, which may include meniscal tears, ligament injuries, or degenerative changes. The cyst may arise due to a tear in the meniscus, leading to the accumulation of fluid within the meniscal tissue. Symptoms typically include knee pain, swelling, and limited range of motion. Diagnosis is usually confirmed through imaging studies such as MRI, which can reveal the cyst's presence and any associated meniscal tears. Treatment options may vary from conservative management, including physical therapy and anti-inflammatory medications, to surgical interventions such as arthroscopic meniscectomy or meniscus repair, depending on the severity of the condition and the patient's overall health status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of meniscal cysts.
  • Need for precise imaging documentation to confirm diagnosis.
  • Differentiation from other knee pathologies such as ligament injuries.
  • Potential for concurrent conditions requiring additional coding.

Audit Risk Factors

  • Inadequate documentation of imaging studies.
  • Failure to specify the laterality of the knee.
  • Lack of clarity in treatment plans and outcomes.
  • Misidentification of the cyst as a separate condition rather than a complication of a meniscal tear.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and pre- and post-operative assessments.

Common Clinical Scenarios

Patients presenting with knee pain and swelling, often after sports injuries or degenerative changes.

Billing Considerations

Ensure clear documentation of the cyst's characteristics and any associated meniscal tears.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-meniscal surgery or with chronic knee pain.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M23.005 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics, including laterality and associated conditions
  • Include any relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M23.005 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

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

Clinical Scenario

Used when a cystic meniscus is surgically treated.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic documentation must clearly outline the necessity for surgery.

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 patient records and facilitating better treatment planning.

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 patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like cystic meniscus, improving the accuracy of patient records and facilitating better treatment planning.

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 treatment for a cystic meniscus?

Treatment may vary from conservative management, such as physical therapy and anti-inflammatory medications, to surgical options like arthroscopic meniscectomy or repair, depending on the severity of symptoms and the presence of associated meniscal tears.