ICD-10 Coding for Chondromalacia of the Right Knee(M22.41, M94.261)
Complete ICD-10-CM coding and documentation guide for Chondromalacia 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 Chondromalacia of the Right Knee
M22.4-M22.49Primary Range
Chondromalacia patellae
This range includes conditions related to the softening and damage of the cartilage on the underside of the kneecap.
Chondromalacia of other sites
This range covers chondromalacia affecting areas of the knee other than the patella, such as the femoral or tibial cartilage.
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 the chondromalacia is isolated to the patellar cartilage. |
|
| M94.261 | Chondromalacia, right knee | Use when chondromalacia affects non-patellar cartilage. |
|
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 right knee
Essential facts and insights about Chondromalacia of the Right Knee
Primary ICD-10-CM Codes for chondromalacia right knee
Decision Criteria
clinical Criteria
- Presence of patellar-specific symptoms and MRI findings
coding Criteria
- Excludes femoral or tibial cartilage involvement
Applicable To
- Patellar cartilage damage
Excludes
Clinical Validation Requirements
- Anterior knee pain
- Positive Clarke's test
- MRI showing patellar cartilage thinning
Code-Specific Risks
- Incorrectly coding when femoral involvement is present
Coding Notes
- Ensure documentation specifies the patellar involvement to avoid confusion with M94.261.
M94.261 - Chondromalacia, right knee
Use when chondromalacia affects non-patellar cartilage.
Applicable To
- Femoral or tibial cartilage damage
Excludes
- M22.41
Clinical Validation Requirements
- Pain in medial/lateral joint line
- MRI showing femoral/tibial cartilage damage
Coding Notes
Ensure documentation specifies non-patellar involvement to avoid confusion with M22.41.
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 of the Right 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 ambiguity in treatment plans., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential claim rejections or denials.
Mitigation Strategy
Always document 'right' or 'left' knee in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Violates ICD-10 coding rules., Data Quality: Leads to inaccurate clinical data recording.
Mitigation Strategy
Select the code based on the specific cartilage involved, not both.
Impact
Risk of using unspecified codes due to lack of detailed documentation.
Mitigation Strategy
Implement documentation templates that require specific anatomical details.
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 of the Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chondromalacia of the Right Knee
Use these documentation templates to ensure complete and accurate documentation for Chondromalacia of the Right Knee. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for chondromalacia
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Functional assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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