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ICD-10 Guide
DiagnosesAnterior Cruciate Ligament Rupture

Anterior Cruciate Ligament Rupture

ICD-10 Coding for ACL Rupture(S83.511A, S83.512A)

PRIMARY SPECIALTYOrthopedics
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Anterior Cruciate Ligament Rupture?
Essential facts and insights about ACL Rupture

Key Clinical Considerations:

  • Presence of a 'pop' sound at the time of injury
  • Immediate swelling and pain in the knee
  • Inability to bear weight on the affected leg
  • Positive result on the Lachman's test or anterior drawer test

Clinical Information

Clinical Criteria & Documentation Requirements

  • Detailed description of the patient's symptoms
  • Results of physical examination, specifically knee stability tests
  • Confirmation of the diagnosis through imaging studies such as MRI
  • Specific location of the rupture, whether it is right or left knee

Coding Guidelines

Usage Guidelines & Examples

  • S83.511A is used for initial encounter for right knee ACL rupture
  • S83.512A is used for initial encounter for left knee ACL rupture
  • These codes are specific for ACL rupture and should not be confused with codes for other knee ligament injuries

Code Exclusions

Important Exclusions

  • Sprains and strains of other parts of the knee
  • Chronic conditions of the knee such as osteoarthritis

Related ICD-10 Codes

Primary Codes
S83.511A
Rupture of anterior cruciate ligament of right knee, initial encounter
S83.512A
Rupture of anterior cruciate ligament of left knee, initial encounter
Ancillary Codes
W01.0XXA
Y93.64
Differential Codes
M23.51
M23.52

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Patients who have sustained a traumatic knee injury
  • Athletes who participate in sports that involve sudden stops and changes in direction

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Patient presents with acute onset of knee pain following a 'pop' sound during sports activity. Physical examination reveals instability of the knee. MRI confirms rupture of the anterior cruciate ligament.

Template 2

Patient unable to bear weight on the left leg due to severe knee pain and swelling. Lachman's test positive. Imaging studies confirm left knee ACL rupture.

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Can these codes be used for follow-up visits?

No, these codes are for initial encounters. For subsequent visits, use the appropriate 'D' extension.

When should this code be used?

These codes should be used when a patient presents with a new ACL rupture confirmed by clinical and imaging findings.