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ICD-10 Guide
ICD-10 CodesM23.009

M23.009

Billable

Cystic meniscus, unspecified meniscus, unspecified knee

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

Code Description

ICD-10 M23.009 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified meniscus, unspecified knee.

Key Diagnostic Point:

Cystic meniscus refers to a condition where a cyst forms within the meniscus of the knee, which is a crescent-shaped cartilage that cushions the knee joint. This condition can lead to internal derangements of the knee, often resulting in pain, swelling, and limited range of motion. The cyst may develop due to degeneration, trauma, or as a result of a meniscal tear. Patients may present with symptoms such as joint locking, clicking, or a sensation of instability. Diagnosis typically involves imaging studies such as MRI, which can reveal the presence of a cyst and any associated meniscal tears or ligament injuries. Treatment options may include conservative management with physical therapy and anti-inflammatory medications, or surgical intervention such as 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

  • Variability in presentation and symptoms among patients
  • Need for precise imaging studies to confirm diagnosis
  • Differentiation from other knee conditions such as ligament injuries
  • Potential for concurrent meniscal tears or other knee pathologies

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to document imaging results that support the diagnosis
  • Incorrect coding of concurrent conditions or procedures
  • Lack of clarity on the treatment plan and follow-up care

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with knee pain and swelling, often after an injury or with chronic degeneration.

Billing Considerations

Ensure that the documentation clearly outlines the extent of the meniscal involvement and any associated procedures performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations including functional assessments and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Document the patient's functional limitations and response to conservative treatment.

Coding Guidelines

Inclusion Criteria

Use M23.009 When
  • According to ICD
  • 10 guidelines, M23
  • 009 should be used when the specific meniscus involved is not documented
  • Coders should ensure that the clinical documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use M23.009 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, surgical

Clinical Scenario

Used when performing arthroscopic surgery to address the cystic meniscus.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and any findings during the procedure.

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.

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.

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.

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 M23.009 and M23.001?

M23.009 is used when the specific meniscus involved is not documented, while M23.001 specifies a cystic meniscus in the medial meniscus of the right knee.