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ICD-10 Guide
ICD-10 CodesM23.006

M23.006

Billable

Cystic meniscus, unspecified meniscus, right knee

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

Code Description

ICD-10 M23.006 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified meniscus, right knee.

Key Diagnostic Point:

Cystic meniscus refers to a condition where a cyst forms within the meniscus of the knee joint, which can lead to pain, swelling, and limited mobility. The meniscus is a C-shaped cartilage that acts as a cushion between the femur (thigh bone) and tibia (shin bone). In the right knee, the unspecified meniscus indicates that the specific meniscal structure affected (medial or lateral) is not clearly identified. Cystic changes in the meniscus can occur due to degeneration, trauma, or as a result of meniscal tears. These cysts may be asymptomatic or can cause significant discomfort, particularly during activities that involve knee flexion or weight-bearing. 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 remove the cyst or repair the meniscus. Accurate coding 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

  • Unspecified meniscus complicates diagnosis and treatment coding.
  • Differentiating between cystic changes and meniscal tears requires detailed documentation.
  • Potential for co-existing ligament injuries increases coding complexity.
  • Variability in treatment approaches necessitates precise coding for reimbursement.

Audit Risk Factors

  • Inadequate documentation of the specific meniscus affected.
  • Failure to document associated symptoms or functional limitations.
  • Lack of imaging studies to support the diagnosis.
  • Inconsistent coding of related procedures or treatments.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with knee pain, swelling, or mechanical symptoms due to meniscal cysts.

Billing Considerations

Ensure clarity in documentation regarding the type of meniscal injury and any associated ligamentous injuries.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes detailing functional limitations.

Common Clinical Scenarios

Patients undergoing rehabilitation post-meniscal surgery or conservative management for cystic changes.

Billing Considerations

Document functional outcomes and response to therapy to support coding for rehabilitation services.

Coding Guidelines

Inclusion Criteria

Use M23.006 When
  • Follow official ICD
  • CM guidelines for coding musculoskeletal disorders
  • Ensure that the documentation supports the diagnosis of cystic meniscus and any associated conditions
  • Include details about the patient's symptoms, imaging findings, and treatment plans

Exclusion Criteria

Do NOT use M23.006 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when performing arthroscopy to evaluate the cystic meniscus.

Documentation Requirements

Operative report detailing findings and procedures performed.

Specialty Considerations

Orthopedic surgeons should document the rationale for arthroscopy and any findings related to the cyst.

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 reimbursement processes. M23.006 provides a clear designation for cystic changes, which aids in treatment planning and outcome tracking.

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 reimbursement processes. M23.006 provides a clear designation for cystic changes, which aids in treatment planning and outcome tracking.

Reimbursement & Billing Impact

reimbursement processes. M23.006 provides a clear designation for cystic changes, which aids in treatment planning and outcome tracking.

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 difference between cystic meniscus and meniscal tear?

Cystic meniscus refers to the formation of a cyst within the meniscus, which may or may not be associated with a tear. A meniscal tear is a specific injury to the meniscus that can lead to pain and mechanical symptoms. Both conditions can coexist, but they require different management approaches.