ICD-10 Coding for Arthritis Knee(M17.0, M17.11)
Complete ICD-10-CM coding and documentation guide for Arthritis Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arthritis Knee
M17.0-M17.9Primary Range
Osteoarthritis of the knee
This range includes codes for primary, secondary, and unspecified osteoarthritis of the knee, covering different types and laterality.
Rheumatoid arthritis with rheumatoid factor
Includes codes for rheumatoid arthritis affecting the knee, which may be confused with osteoarthritis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M17.0 | Bilateral primary osteoarthritis of knee | Use when both knees are affected by primary osteoarthritis. |
|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when only the right knee is affected by primary osteoarthritis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for arthritis knee
Essential facts and insights about Arthritis Knee
Primary ICD-10-CM Codes for arthritis knee
Decision Criteria
clinical Criteria
- Bilateral knee pain with X-ray evidence of osteoarthritis
Applicable To
- Primary osteoarthritis of both knees
Excludes
- Rheumatoid arthritis (M05.-)
Clinical Validation Requirements
- X-ray showing osteophytes and joint space narrowing
- Clinical history of bilateral knee pain and stiffness
Code-Specific Risks
- Ensure bilateral involvement is documented.
Coding Notes
- Document bilateral involvement and primary nature of osteoarthritis.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when only the right knee is affected by primary osteoarthritis.
Applicable To
- Primary osteoarthritis of right knee
Excludes
- Rheumatoid arthritis (M05.-)
Clinical Validation Requirements
- X-ray showing osteophytes and joint space narrowing in the right knee
- Clinical history of right knee pain and stiffness
Coding Notes
Document right knee involvement and primary nature of osteoarthritis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Morbid obesity
E66.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Rheumatoid arthritis, right knee
M05.361Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Arthritis Knee to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.0.
Impact
Clinical: May lead to incorrect diagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include imaging results in documentation., Cross-check radiology reports.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always specify laterality (right, left, bilateral) when documented.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement checklist for documentation review.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Arthritis Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthritis Knee
Use these documentation templates to ensure complete and accurate documentation for Arthritis Knee. These templates include all required elements for proper coding and billing.
Chronic knee pain evaluation
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Arthritis Knee? Ask your questions below.