ICD-10 Coding for Chondromalacia Patella(M22.4X, M94.26X)
Complete ICD-10-CM coding and documentation guide for Chondromalacia Patella. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chondromalacia 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 |
|---|---|---|---|
| M22.4X | Chondromalacia patellae | Use when there is confirmed patellar cartilage damage with specified laterality. |
|
| M94.26X | Chondromalacia, knee | Use for cartilage damage not involving 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 patella
Essential facts and insights about Chondromalacia Patella
Primary ICD-10-CM Codes for chondromalacia patella
Decision Criteria
clinical Criteria
- Presence of anterior knee pain and patellar cartilage damage on imaging.
Applicable To
- Patellar cartilage damage
Excludes
- M94.26 - Chondromalacia, knee
Clinical Validation Requirements
- Anterior knee pain
- MRI showing patellar cartilage erosion
Code-Specific Risks
- Confusion with general knee chondromalacia codes
Coding Notes
- Ensure laterality is specified.
M94.26X - Chondromalacia, knee
Use for cartilage damage not involving the patella.
Applicable To
- Non-patellar cartilage damage
Excludes
- M22.4X - Chondromalacia patellae
Clinical Validation Requirements
- Pain localized to medial/lateral joint line
- MRI showing non-patellar lesions
Coding Notes
Do not use with M22.4X.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chondromalacia Patella to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.4X.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials.
Mitigation Strategy
Always confirm patellar involvement in documentation.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Violates ICD-10 Excludes1 note., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use only M22.4X for patellar lesions.
Impact
Using M22.4X and M94.26X together.
Mitigation Strategy
Educate coders on Excludes1 notes.
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 Patella, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chondromalacia Patella
Use these documentation templates to ensure complete and accurate documentation for Chondromalacia Patella. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of knee pain
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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