ICD Code M67.52

ICD code M67.52 is used to identify and classify the medical condition known as plica syndrome affecting the left knee. Plica syndrome occurs when the plica, a fold in the synovial membrane of the knee joint, becomes irritated or inflamed. This can lead to symptoms such as knee pain, swelling, and a feeling of instability or clicking in the knee. The code M67.52 helps healthcare providers document this specific condition for accurate diagnosis, treatment planning, and billing purposes within the healthcare revenue cycle.

When to use the ICD code for Plica syndrome, left knee:

1. Patient Presentation:
- Patient reports pain in the left knee, particularly during activities such as squatting or climbing stairs.

2. Physical Examination Findings:
- Tenderness along the medial aspect of the left knee.
- Swelling or effusion in the left knee joint.

3. Range of Motion Assessment:
- Limited range of motion in the left knee, particularly in flexion and extension.

4. Palpation:
- Palpable plica or thickened synovial tissue in the left knee during examination.

5. Imaging Studies:
- MRI or ultrasound shows evidence of plica formation or irritation in the left knee.

6. Response to Conservative Treatment:
- Symptoms persist despite conservative management such as rest, ice, compression, and elevation (RICE), or physical therapy.

7. Exclusion of Other Conditions:
- Other potential causes of knee pain (e.g., meniscus tears, ligament injuries, arthritis) have been ruled out through clinical evaluation and imaging.

8. Duration of Symptoms:
- Symptoms have been present for a significant duration, typically several weeks, without improvement.

9. Functional Impact:
- The condition is affecting the patient's daily activities or athletic performance, warranting further evaluation and diagnosis.

For the ICD code M67.52, which pertains to plica syndrome of the left knee, the relevant CPT codes that may be applicable for treatment include:

1. 29870 - Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure).

2. 29875 - Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection).

3. 29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments.

4. 29877 - Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty).

5. 29881 - Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving).

These CPT codes are typically used in the context of arthroscopic procedures that may be performed to address issues related to plica syndrome in the knee. It's important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario.

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