M67.52 identifies plica syndrome specifically affecting the left knee — irritation or inflammation of a synovial membrane fold within the left knee joint, classified under other disorders of synovium and tendon.
Verified May 8, 2026 · 5 sources ↓
- Status
- Billable
- Chapter
- 13
- Related CPT
- 8
- Region
- Knee
Documentation tips
What should appear in the chart to support M67.52.
Source · Editorial brief grounded in 5 cited references ↓
- Explicitly name 'left knee' in the assessment — 'plica syndrome' without laterality forces a drop to M67.50 (unspecified).
- Record physical exam findings that support the diagnosis: medial knee tenderness, palpable thickened plica band, clicking or pseudolocking with flexion.
- Note MRI or ultrasound findings when imaging is obtained — describe synovial fold thickening or impingement to justify medical necessity.
- Document the conservative treatment course (duration, modalities tried, response) before arthroscopic intervention to support surgical necessity.
- If both knees are symptomatic, document each side separately; report M67.51 and M67.52 together — there is no bilateral plica syndrome code.
Related CPT procedures
Procedure codes commonly billed with M67.52. Linking the right diagnosis to the right procedure is what establishes medical necessity.
Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis
Common coding pitfalls
The recurring mistakes coders make with M67.52 and adjacent codes.
Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓
- Defaulting to M67.50 (unspecified knee) when the note clearly documents the left side — always assign M67.52 when laterality is present.
- Confusing plica syndrome with meniscal or patellofemoral codes; plica is a synovial membrane disorder under M67.5, not a cartilage or meniscus category.
- Reporting M67.52 with a duplicate symptom code (e.g., M25.562 left knee pain) when pain is integral to the plica diagnosis — the symptom does not add specificity and is redundant.
- Selecting 29881 (meniscectomy) as the arthroscopic CPT when only plica resection was performed — 29875 (synovectomy, limited) is the correct pairing for isolated plica shelf resection.
Clinical context
Source · Editorial summary grounded in 5 cited references ↓
Use M67.52 when the provider has documented plica syndrome with explicit left-side laterality. Plica syndrome involves pathologic thickening or inflammation of a remnant synovial fold (plica) inside the knee joint, producing medial knee pain, clicking, pseudolocking, or a palpable band. The condition is distinct from meniscal pathology, chondromalacia, and patellofemoral syndrome — all of which can mimic it clinically.
M67.52 sits within the M67.5 family: M67.51 is right knee, M67.52 is left knee, and M67.50 is unspecified knee. Drop to M67.50 only when the operative or clinical note genuinely omits laterality — do not default to unspecified when the chart clearly names the left side. There is no bilateral code in this family; if both knees are affected, report M67.51 and M67.52 together.
The diagnosis typically follows failed conservative care (NSAIDs, physical therapy, activity modification) and is confirmed by clinical examination findings — palpable plica, medial joint line tenderness — often supported by MRI showing a thickened synovial band. Arthroscopic confirmation is the gold standard. Code M67.52 applies across the care continuum: office evaluation, imaging workup, injection, and arthroscopic plica resection encounters.
Sibling codes
Other billable codes under M67.5 (laterality / anatomic variants).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01What is the difference between M67.52 and M67.50?
02Is there a bilateral plica syndrome code?
03Which CPT code pairs with M67.52 for arthroscopic plica resection?
04Can M67.52 be used at the initial evaluation visit before a confirmed diagnosis?
05Does M67.52 require a 7th character extension?
06What MS-DRGs does M67.52 map to for inpatient coding?
07Can knee pain (M25.562) be coded alongside M67.52?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
- 02icd10data.comhttps://www.icd10data.com/ICD10CM/Codes/M00-M99/M65-M67/M67-/M67.52
- 03aapc.comhttps://www.aapc.com/codes/icd-10-codes/M67.52
- 04mdclarity.comhttps://www.mdclarity.com/icd-codes/m67-52
- 05cms.govhttps://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptsorthopedics1.pdf
Mira AI Scribe
The Mira AI Scribe captures left-side laterality, medial knee tenderness on palpation, presence of a palpable plica band, clicking or pseudolocking with range of motion, MRI findings of synovial fold thickening, and prior conservative treatment history. Capturing these specifics prevents a downcode to M67.50 (unspecified knee) and supports medical necessity documentation for arthroscopic plica resection.
See how Mira captures M67.52 documentation