ICD-10 Coding for Degenerative Arthritis of the Knee(M17.0, M17.11, M17.31, M17.5)
Complete ICD-10-CM coding and documentation guide for Degenerative Arthritis of the Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Arthritis of the Knee
M17.0-M17.9Primary Range
Osteoarthritis of the knee
This range includes all codes related to osteoarthritis of the knee, covering primary, secondary, and post-traumatic forms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M17.0 | Bilateral primary osteoarthritis of knee | Use when both knees are affected by primary osteoarthritis without a history of trauma. |
|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when primary osteoarthritis affects only the right knee. |
|
| M17.31 | Post-traumatic osteoarthritis, right knee | Use when osteoarthritis is due to a previous injury to the right knee. |
|
| M17.5 | Secondary osteoarthritis of knee | Use when osteoarthritis is secondary to another condition like obesity. |
|
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 degenerative arthritis knee
Essential facts and insights about Degenerative Arthritis of the Knee
Primary ICD-10-CM Codes for degenerative arthritis knee
Decision Criteria
clinical Criteria
- Bilateral knee pain with radiographic evidence
Applicable To
- Bilateral knee osteoarthritis
Excludes
- Post-traumatic osteoarthritis (M17.3-)
Clinical Validation Requirements
- Radiographic evidence of bilateral joint space narrowing and osteophytes
Code-Specific Risks
- Ensure bilateral involvement is documented.
Coding Notes
- Primary osteoarthritis is the default if no cause is specified.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when primary osteoarthritis affects only the right knee.
Applicable To
- Right knee osteoarthritis
Excludes
- Post-traumatic osteoarthritis (M17.3-)
Clinical Validation Requirements
- X-ray showing medial compartment degeneration
Coding Notes
Document specific knee affected.
M17.31 - Post-traumatic osteoarthritis, right knee
Use when osteoarthritis is due to a previous injury to the right knee.
Applicable To
- Right knee osteoarthritis due to previous injury
Excludes
- Primary osteoarthritis (M17.1-)
Clinical Validation Requirements
- History of trauma with subsequent degenerative changes
Coding Notes
Document the specific trauma history.
M17.5 - Secondary osteoarthritis of knee
Use when osteoarthritis is secondary to another condition like obesity.
Applicable To
- Knee osteoarthritis due to another condition
Excludes
- Primary osteoarthritis (M17.0-M17.1)
Clinical Validation Requirements
- Documentation of underlying condition causing OA
Coding Notes
Sequence underlying condition first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Body mass index (BMI) 40.0-44.9, adult
Z68.41Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Bilateral secondary osteoarthritis of knee
M17.2Unilateral primary osteoarthritis, left knee
M17.12Post-traumatic osteoarthritis, left knee
M17.32Bilateral primary osteoarthritis of knee
M17.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Degenerative Arthritis of the Knee to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.0.
Impact
Clinical: Misrepresents the patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the underlying condition.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Ensure laterality and primary vs. secondary are documented.
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Ensure laterality is always specified in documentation.
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 Degenerative Arthritis of the Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Arthritis of the Knee
Use these documentation templates to ensure complete and accurate documentation for Degenerative Arthritis of the Knee. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for knee osteoarthritis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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