ICD-10 Coding for Chondromalacia Knee(M22.41, M22.42, M94.261, M94.262)
Complete ICD-10-CM coding and documentation guide for Chondromalacia Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chondromalacia 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 |
|---|---|---|---|
| M22.41 | Chondromalacia patellae, right knee | Use when chondromalacia is isolated to the right patella. |
|
| M22.42 | Chondromalacia patellae, left knee | Use when chondromalacia is isolated to the left patella. |
|
| M94.261 | Chondromalacia, right knee | Use when chondromalacia affects areas beyond the patella in the right knee. |
|
| M94.262 | Chondromalacia, left knee | Use when chondromalacia affects areas beyond the patella in the left knee. |
|
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 chondromalacia knee
Essential facts and insights about Chondromalacia Knee
Primary ICD-10-CM Codes for chondromalacia knee
Decision Criteria
clinical Criteria
- Confirmed patellar involvement via imaging
Applicable To
- Chondromalacia of the patella
Excludes
- Chondromalacia of other sites (M94.26)
Clinical Validation Requirements
- MRI showing cartilage loss at the patella
- Positive patellar grind test
Code-Specific Risks
- Risk of unspecified laterality if not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
M22.42 - Chondromalacia patellae, left knee
Use when chondromalacia is isolated to the left patella.
Applicable To
- Chondromalacia of the patella
Excludes
- Chondromalacia of other sites (M94.26)
Clinical Validation Requirements
- MRI showing cartilage loss at the patella
- Positive patellar grind test
Coding Notes
Ensure laterality is documented to avoid unspecified codes.
M94.261 - Chondromalacia, right knee
Use when chondromalacia affects areas beyond the patella in the right knee.
Applicable To
- Chondromalacia involving femoral condyles
Excludes
- Chondromalacia of patella (M22.4)
Clinical Validation Requirements
- MRI showing cartilage loss in femoral condyles
- Positive squat test
Coding Notes
Cannot be used with M22.4 for the same knee.
M94.262 - Chondromalacia, left knee
Use when chondromalacia affects areas beyond the patella in the left knee.
Applicable To
- Chondromalacia involving femoral condyles
Excludes
- Chondromalacia of patella (M22.4)
Clinical Validation Requirements
- MRI showing cartilage loss in femoral condyles
- Positive squat test
Coding Notes
Cannot be used with M22.4 for the same knee.
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 Chondromalacia Knee to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.41.
Impact
Clinical: Leads to ambiguous treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always document the affected knee., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Violates ICD-10 Excludes1 note., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use only M94.26x if chondromalacia affects areas beyond the patella.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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 Chondromalacia Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chondromalacia Knee
Use these documentation templates to ensure complete and accurate documentation for Chondromalacia Knee. These templates include all required elements for proper coding and billing.
Orthopedic Evaluation for Chondromalacia
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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