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ICD-10 Guide
ICD-10 CodesM23.007

M23.007

Billable

Cystic meniscus, unspecified meniscus, left knee

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

Code Description

ICD-10 M23.007 is a billable code used to indicate a diagnosis of cystic meniscus, unspecified meniscus, left knee.

Key Diagnostic Point:

Cystic meniscus refers to a condition where a cyst forms within the meniscus of the knee joint, specifically in the left knee in this case. The meniscus is a C-shaped cartilage that acts as a cushion between the femur (thigh bone) and tibia (shin bone). Cystic changes can occur due to degeneration, trauma, or as a result of a meniscal tear. Patients may present with symptoms such as knee pain, swelling, and limited range of motion. Diagnosis typically involves imaging studies such as MRI, which can reveal the presence of a cyst and any associated meniscal tears or internal derangements. 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

  • Differentiating between cystic changes and other meniscal injuries
  • Need for precise documentation of the location and type of meniscal involvement
  • Potential for associated ligament injuries that may complicate coding
  • Variability in treatment approaches based on the severity of the condition

Audit Risk Factors

  • Inadequate documentation of imaging results
  • Failure to specify the type of meniscal injury
  • Incorrect linkage of the diagnosis to the procedure performed
  • Lack of clarity on conservative versus surgical management

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with knee pain and swelling, often following an injury or degenerative changes.

Billing Considerations

Ensure that all findings from imaging and physical exams are documented to support the diagnosis.

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

Documenting the patient's functional limitations and response to therapy is crucial.

Coding Guidelines

Inclusion Criteria

Use M23.007 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M23.007 When
  • Exclude conditions that do not meet the criteria for cystic meniscus

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, surgical

Clinical Scenario

Used for arthroscopic meniscus repair or cyst removal.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specific findings and procedures performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of conditions like cystic meniscus, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of conditions like cystic meniscus, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 significance of coding M23.007?

Coding M23.007 accurately reflects the presence of a cystic meniscus, which can impact treatment decisions and reimbursement.