Lateral disloc of proximal end of tibia, unsp knee, init

This diagnosis code indicates a complete displacement of the upper portion of the shin bone (tibia) from its normal articulation with the thigh bone (femur) on the outer side of the knee joint. The specific knee (left or right) is not documented, and this is the first time the patient is being treated for this injury.

This code is appropriate for initial encounters when a patient presents with a laterally dislocated proximal tibia, and the medical record does not specify which knee is affected. It would be used following an acute traumatic event leading to the dislocation.

• Ensure documentation clearly states "lateral dislocation" and "proximal end of tibia."
• Verify that the encounter is indeed the initial treatment for this specific injury.
• If the laterality (left or right knee) is documented, select a more specific code.