ICD-10 Coding for Arthritis of Right Knee(M17.11, M17.31)
Complete ICD-10-CM coding and documentation guide for Arthritis of Right Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arthritis of Right Knee
M15-M19Primary Range
Arthritis and osteoarthritis
This range includes codes for various forms of arthritis, including osteoarthritis, which is relevant for coding arthritis of the right knee.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when the patient has primary osteoarthritis in the right knee without a history of trauma. |
|
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | Use when osteoarthritis is secondary to a previous knee injury. |
|
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 of right knee
Essential facts and insights about Arthritis of Right Knee
Primary ICD-10-CM Codes for arthritis of right knee
Decision Criteria
clinical Criteria
- Presence of osteophytes and joint space narrowing on imaging
documentation Criteria
- Documentation of 'primary' osteoarthritis and right knee laterality
Applicable To
- Primary osteoarthritis of the right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- X-ray showing joint space narrowing
- Physical exam findings of crepitus and reduced range of motion
Code-Specific Risks
- Ensure laterality is documented to avoid unspecified coding.
Coding Notes
- Ensure documentation specifies 'primary' osteoarthritis and includes imaging findings.
M17.31 - Unilateral post-traumatic osteoarthritis, right knee
Use when osteoarthritis is secondary to a previous knee injury.
Applicable To
- Post-traumatic osteoarthritis of the right knee
Excludes
- Primary osteoarthritis (M17.11)
Clinical Validation Requirements
- History of significant knee trauma or surgery
- Imaging showing degenerative changes at the site of previous injury
Coding Notes
Link the osteoarthritis to the specific traumatic event.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Arthritis of Right Knee to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.11.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include imaging results in the documentation., Review documentation templates for completeness.
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always document and code the specific side affected.
Impact
Failure to document laterality can lead to audit findings.
Mitigation Strategy
Implement a checklist to ensure laterality is documented.
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 of Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthritis of Right Knee
Use these documentation templates to ensure complete and accurate documentation for Arthritis of Right Knee. These templates include all required elements for proper coding and billing.
Primary osteoarthritis of the right knee
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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