ICD-10 Coding for Degenerative Osteoarthritis of the Knee(M17.0, M17.11)
Complete ICD-10-CM coding and documentation guide for Degenerative Osteoarthritis 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 Osteoarthritis 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, post-traumatic, and unspecified types.
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 with confirmed imaging findings. |
|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when only the right knee is affected by primary osteoarthritis. |
|
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 bilateral knee osteoarthritis
Essential facts and insights about Degenerative Osteoarthritis of the Knee
Primary ICD-10-CM Codes for degenerative osteoarthritis knee
Decision Criteria
clinical Criteria
- Bilateral knee involvement with primary osteoarthritis features
Applicable To
- Primary osteoarthritis of both knees
Clinical Validation Requirements
- X-ray evidence of joint space narrowing
- Osteophyte formation
Code-Specific Risks
- Ensure bilateral involvement is documented
Coding Notes
- Document laterality and confirm primary osteoarthritis through imaging.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when only the right knee is affected by primary osteoarthritis.
Applicable To
- Primary osteoarthritis of right knee
Excludes
- Post-traumatic osteoarthritis (M17.2-M17.5)
Clinical Validation Requirements
- X-ray evidence of joint space narrowing
- Osteophyte formation
Coding Notes
Document laterality and confirm primary osteoarthritis through 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 Osteoarthritis 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: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections or audits.
Mitigation Strategy
Educate providers on documentation standards, Implement EHR prompts for specificity
Impact
Reimbursement: May lead to claim denials due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure laterality is coded when specified in the documentation.
Impact
Inaccurate coding of laterality can lead to audit issues.
Mitigation Strategy
Regular audits of clinical documentation to ensure compliance.
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 Osteoarthritis of the Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Osteoarthritis of the Knee
Use these documentation templates to ensure complete and accurate documentation for Degenerative Osteoarthritis of the Knee. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for knee osteoarthritis
Specialty: OrthopedicsRequired Elements
- Pain assessment
- Imaging findings
- Functional limitations
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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