ICD-10 Coding for Arthritis of the Right Knee(M17.11, M17.31)
Complete ICD-10-CM coding and documentation guide for Arthritis of the 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 the Right Knee
M15-M19Primary Range
Arthritis and osteoarthritis
This range includes all forms of arthritis and osteoarthritis, specifically focusing on the knee joint for this condition.
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 primary OA is confirmed by imaging and no trauma history is present. |
|
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | Use when OA is secondary to a documented knee injury or surgery. |
|
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 right knee
Essential facts and insights about Arthritis of the Right Knee
Primary ICD-10-CM Codes for arthritis right knee
Decision Criteria
clinical Criteria
- X-ray shows osteophytes and joint space narrowing
documentation Criteria
- No history of knee trauma
Applicable To
- Primary osteoarthritis of the right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- X-ray showing joint space narrowing, osteophytes
- No history of trauma
Code-Specific Risks
- Incorrectly using for post-traumatic cases
Coding Notes
- Ensure imaging confirms OA and no trauma history is documented.
M17.31 - Unilateral post-traumatic osteoarthritis, right knee
Use when OA is secondary to a documented knee injury or surgery.
Applicable To
- Post-traumatic osteoarthritis of the right knee
Excludes
- Primary osteoarthritis (M17.11)
Clinical Validation Requirements
- History of knee trauma or surgery
- Imaging showing joint degeneration
Coding Notes
Document the specific injury or surgery that led to OA.
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 the 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: Inaccurate diagnosis, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always link OA to a specific cause if secondary, Review patient history thoroughly
Impact
Reimbursement: Potential denial of claims due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Use specific codes like M17.11 for right knee OA
Impact
Using unspecified codes when laterality is documented
Mitigation Strategy
Always use specific codes like M17.11 or M17.31
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 the Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthritis of the Right Knee
Use these documentation templates to ensure complete and accurate documentation for Arthritis of the Right Knee. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for right knee OA
Specialty: OrthopedicsRequired Elements
- Patient history
- 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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