December 15, 2016

Question:
If a patient presents with MRI findings confirming a traumatic right ACL tear (sprain) S83.511A, should we report additional codes to describe the symptoms knee pain, swelling, or difficulty walking?

Answer:
No, signs and symptoms that are associated routinely with a disease or injury should not be assigned additional codes unless you are instructed to do so by the classification.

*This response is based on the best information available as of 12/15/16.