ICD-10 Coding for Chondromalacia Left Knee(M22.42, M94.262)
Complete ICD-10-CM coding and documentation guide for Chondromalacia Left Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chondromalacia Left Knee
M22.4-M22.42Primary Range
Disorders of patella
This range includes specific codes for chondromalacia of the patella, which is the primary condition when the patella is involved.
Chondromalacia of other joints
This range is used when chondromalacia affects parts of the knee other than the patella.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M22.42 | Chondromalacia patellae, left knee | Use this code when the chondromalacia is specifically documented as affecting the patella. |
|
| M94.262 | Chondromalacia, left knee joint | Use this code when chondromalacia is documented in the knee joint but not specifically the patella. |
|
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 left knee
Essential facts and insights about Chondromalacia Left Knee
Primary ICD-10-CM Codes for chondromalacia left knee
Decision Criteria
clinical Criteria
- MRI shows patellar cartilage degeneration
documentation Criteria
- Documentation specifies 'patella' or 'patellofemoral'
Applicable To
- Chondromalacia of the patella
Excludes
- Chondromalacia of other parts of the knee
Clinical Validation Requirements
- MRI showing patellar cartilage thinning ≥50%
- Positive patellar grind test
Code-Specific Risks
- Incorrect use if documentation does not specify patella involvement
Coding Notes
- Ensure documentation specifies patellar involvement to avoid incorrect coding.
M94.262 - Chondromalacia, left knee joint
Use this code when chondromalacia is documented in the knee joint but not specifically the patella.
Applicable To
- Chondromalacia of the knee joint excluding patella
Excludes
- Chondromalacia of the patella
Clinical Validation Requirements
- Arthroscopic visualization of femoral/tibial cartilage fibrillation
Coding Notes
Ensure documentation does not specify patellar involvement to avoid incorrect coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in left knee
M25.562Differential 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 Left Knee to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.42.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or audits.
Mitigation Strategy
Train staff on documentation specificity., Use templates that prompt for anatomical details.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation explicitly mentions 'patella' or 'patellofemoral'.
Impact
Risk of using non-specific codes for chondromalacia.
Mitigation Strategy
Ensure documentation specifies the exact site of chondromalacia.
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 Left Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chondromalacia Left Knee
Use these documentation templates to ensure complete and accurate documentation for Chondromalacia Left Knee. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for knee pain
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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