ICD-10 Coding for Knee Arthritis(M17.0, M17.11)
Complete ICD-10-CM coding and documentation guide for Knee Arthritis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Knee Arthritis
M17.0-M17.9Primary Range
Osteoarthritis of knee
This range includes codes for primary and secondary osteoarthritis of the knee, specifying laterality and whether the condition is bilateral.
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. |
|
| 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 knee arthritis
Essential facts and insights about Knee Arthritis
Primary ICD-10-CM Codes for knee arthritis
Decision Criteria
clinical Criteria
- Bilateral knee pain with imaging confirmation
Applicable To
- Bilateral knee osteoarthritis
Excludes
- Post-traumatic osteoarthritis (M17.3)
Clinical Validation Requirements
- X-ray evidence of joint space narrowing
- Osteophyte formation
Code-Specific Risks
- Ensure bilateral involvement is documented
Coding Notes
- Document the primary nature of osteoarthritis and confirm bilateral involvement.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when only the right knee is affected by primary osteoarthritis.
Applicable To
- Right knee osteoarthritis
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- X-ray evidence of joint space narrowing
- Morning stiffness >30 minutes
Coding Notes
Document the primary nature of osteoarthritis and confirm right knee involvement.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Knee Arthritis 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 incorrect diagnosis, Regulatory: Non-compliance with coding guidelines, Financial: Potential claim denials
Mitigation Strategy
Ensure imaging results are included in the patient's record
Impact
Reimbursement: May lead to denied claims, Compliance: Non-compliance with ICD-10 specificity requirements, Data Quality: Reduces accuracy of clinical data
Mitigation Strategy
Always specify laterality in documentation
Impact
Failure to document laterality can lead to audit issues
Mitigation Strategy
Implement mandatory laterality fields in EHR templates
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 Knee Arthritis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Knee Arthritis
Use these documentation templates to ensure complete and accurate documentation for Knee Arthritis. These templates include all required elements for proper coding and billing.
Bilateral knee osteoarthritis with failed conservative treatment
Specialty: OrthopedicsRequired Elements
- Patient history
- Imaging results
- Treatment history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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