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ICD-10 Guide
ICD-10 CodesM23.003

M23.003

Billable

Cystic meniscus, unspecified medial meniscus, right knee

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

Code Description

ICD-10 M23.003 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified medial meniscus, right knee.

Key Diagnostic Point:

Cystic meniscus refers to a condition where a cyst forms in the meniscus, a crescent-shaped cartilage in the knee that acts as a cushion between the femur and tibia. In this case, the cyst is located in the medial meniscus of the right knee. This condition can arise due to degenerative changes, trauma, or as a result of a meniscal tear. Patients may present with symptoms such as knee pain, swelling, and limited range of motion. The presence of a cyst can indicate underlying meniscal pathology, often leading to internal derangements of the knee joint. Diagnosis typically involves imaging studies such as MRI, which can reveal the cyst and any associated meniscal tears or ligament injuries. Treatment options may include conservative management, such as physical therapy and anti-inflammatory medications, or surgical intervention, particularly arthroscopic procedures 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 of cystic meniscus
  • Need for precise documentation of imaging findings
  • Differentiation from other meniscal conditions
  • Potential for concurrent ligament injuries

Audit Risk Factors

  • Inadequate documentation of imaging results
  • Failure to specify the type of cyst or associated injuries
  • Misclassification of meniscal tears
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure that all findings related to the meniscus and any associated ligament injuries are documented.

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 coding.

Coding Guidelines

Inclusion Criteria

Use M23.003 When
  • According to ICD
  • 10 guidelines, M23
  • 003 should be used when the cystic meniscus is confirmed through imaging and when the specific meniscus involved is documented
  • It is important to note any associated conditions such as meniscal tears or ligament injuries

Exclusion Criteria

Do NOT use M23.003 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 an arthroscopy to evaluate the cyst and any associated injuries.

Documentation Requirements

Operative report detailing findings and procedures performed.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and findings.

29882CPT Code

Arthroscopy, knee, surgical, with meniscectomy

Clinical Scenario

Used when the cyst is removed and meniscal repair is performed.

Documentation Requirements

Detailed operative report and post-operative care notes.

Specialty Considerations

Ensure that all procedures are documented to support coding.

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. This specificity helps in tracking treatment outcomes and resource utilization.

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. This specificity helps in tracking treatment outcomes and resource utilization.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in tracking treatment outcomes and resource utilization.

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 imaging is required to confirm a cystic meniscus?

MRI is the preferred imaging modality to confirm the presence of a cystic meniscus and assess for associated injuries.

Can M23.003 be used for both acute and chronic cases?

Yes, M23.003 can be used for both acute presentations and chronic conditions as long as the cystic meniscus is documented.