ICD-10 Coding for Degenerative Joint Disorder(M17.0, M17.11)
Complete ICD-10-CM coding and documentation guide for Degenerative Joint Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Joint Disorder
M15-M19Primary Range
Osteoarthritis
This range includes all forms of osteoarthritis, which is synonymous with degenerative joint disorder.
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 bilateral knee osteoarthritis is confirmed by imaging and is primary in nature. |
|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when primary osteoarthritis is confirmed in the right knee only. |
|
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 joint disorder
Essential facts and insights about Degenerative Joint Disorder
Primary ICD-10-CM Codes for degenerative joint disorder
Decision Criteria
clinical Criteria
- Confirmed by imaging showing typical osteoarthritic changes
documentation Criteria
- Documentation must specify primary osteoarthritis and laterality
Applicable To
- Primary osteoarthritis of both knees
Clinical Validation Requirements
- Imaging showing joint space narrowing, osteophytes, and subchondral sclerosis
Code-Specific Risks
- Risk of using unspecified codes when laterality is known
Coding Notes
- Ensure documentation specifies primary osteoarthritis and includes imaging findings.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when primary osteoarthritis is confirmed in the right knee only.
Applicable To
- Primary osteoarthritis of right knee
Excludes
- Post-traumatic osteoarthritis (M17.3-M17.5)
Clinical Validation Requirements
- X-ray showing joint space narrowing and osteophytes on the right knee
Coding Notes
Document specific knee affected and confirm with imaging.
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 Degenerative Joint Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Always include imaging results in the patient's record., Use standardized templates for documentation.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Non-compliance with CMS specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify laterality when known to avoid unspecified codes.
Impact
Audits may focus on the use of unspecified codes when laterality is documented.
Mitigation Strategy
Ensure all documentation specifies laterality and type of osteoarthritis.
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 Joint Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Joint Disorder
Use these documentation templates to ensure complete and accurate documentation for Degenerative Joint Disorder. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for knee osteoarthritis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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