Q&A Coding Meniscal Tear from House calls

[Devang Trivedi]

Hello Laureen/Alicia:

Can you suggest me how should I code "Meniscal Tear" from a house calls? As in house call insurance company sends a provider to their beneficiary's house and mentions all the persisting diagnoses. So as per ICD-9 book current Meniscal tear leads to 836.2 but its current tear code and the next indent is "Old NEC" which is 717.5. So please suggest coding an appropriate code for this situation.

Regards.

 

[Alicia Scott]

Here is the difference in the two:
By the way, this is an excellent question

The key here is really the wording of the documentation you are working with. Now if a report states the injury was a year ago then this of course would be considered old. However if it does not indicate the injury is old then you must use the 836.2. Documentation must be the deciding factor. Look for words like "had" or "degeneartive" Of course you can always ask the physician. Let them know you needs specifics so that you can code to the highest specificity. Always take notes.
836.2 - Dislocation of knee; Other tear of cartilage or meniscus of knee, current
Tear of: cartilage (semilunar) current injury, not specified as medial or lateral, meniscus current injury, not specified as medial or lateral

717.5 - Derangement of meniscus, not elsewhere classified
Congenital discoid meniscus
Cyst of semilunar cartilage
Derangement of semilunar cartilage NOS

717Includes: degeneration of articular cartilage or meniscus of knee; rupture, old of articular cartilage or meniscus of knee; tear, old of articular cartilage or meniscus of knee
Excludes: acute derangement of knee (836.0-836.6), ankylosis (718.5), contracture (718.4), current injury (836.0-836.6), deformity (736.4-736.6), recurrent dislocation (718.3)​

 

[Devang Trivedi]

Yes, I got the meaning but as a house call, it is a kind of annual visit in which physician lists all the existing diagnoses. So my thinking is that it should be old by default. So need to clarify if I am correct...

 

[Alicia Scott]

You don't have a date at all? I think that you are right if this is an annual visit. There does not appear to be any treatment or indication it is new. Was it the reason for the visit?