ICD-10 Coding for Degenerative Osteoarthritis(M17.11)
Complete ICD-10-CM coding and documentation guide for Degenerative Osteoarthritis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Osteoarthritis
M15-M19Primary Range
Arthritis and polyarthritis
This range includes all forms of osteoarthritis, including primary, secondary, and post-traumatic.
Key Information: ICD-10 code for degenerative osteoarthritis
Essential facts and insights about Degenerative Osteoarthritis
Primary ICD-10-CM Code for degenerative osteoarthritis
Decision Criteria
clinical Criteria
- Radiographic evidence of osteoarthritis
documentation Criteria
- Specify laterality and type of osteoarthritis
Applicable To
- Primary osteoarthritis of the right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- Radiographic evidence of joint space narrowing
- Presence of osteophytes
Code-Specific Risks
- Misclassification if laterality is not specified
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Obesity due to excess calories
E66.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Post-traumatic osteoarthritis, right knee
M17.31Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Degenerative Osteoarthritis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.11.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increases risk of non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Use standardized templates that prompt for type and laterality., Regular training on documentation standards.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit failure., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Always document the specific joint and side affected.
Impact
High risk of audit if laterality is not documented.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Osteoarthritis
Use these documentation templates to ensure complete and accurate documentation for Degenerative Osteoarthritis. These templates include all required elements for proper coding and billing.
Primary osteoarthritis of the knee
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Radiographic evidence
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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