ICD-10 Coding for Knee Infection(T84.54XA, M00.861)
Complete ICD-10-CM coding and documentation guide for Knee Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Knee Infection
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T84.54XA | Infection and inflammatory reaction due to internal joint prosthesis, initial encounter | Use when there is a confirmed infection of a knee prosthesis. |
|
| M00.861 | Direct infection of right knee in infectious and parasitic diseases classified elsewhere | Use for septic arthritis in a native knee joint. |
|
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 infection
Essential facts and insights about Knee Infection
Primary ICD-10-CM Codes for knee infection
Decision Criteria
clinical Criteria
- Presence of infection symptoms and positive culture results
Applicable To
- Prosthetic joint infection
Excludes
- Mechanical complication of prosthetic joint
Clinical Validation Requirements
- Synovial fluid WBC >1,700 cells/μL
- Positive synovial fluid culture
Code-Specific Risks
- Incorrect laterality coding
- Missing organism identification
Coding Notes
- Ensure to document the laterality and the specific organism causing the infection.
M00.861 - Direct infection of right knee in infectious and parasitic diseases classified elsewhere
Use for septic arthritis in a native knee joint.
Applicable To
- Septic arthritis of the knee
Excludes
- Infection of prosthetic joint
Clinical Validation Requirements
- Positive blood or synovial fluid culture
- Acute onset of knee pain and swelling
Coding Notes
Ensure documentation specifies the absence of a prosthetic joint.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of artificial knee joint
Z96.65Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Direct infection of right knee in infectious and parasitic diseases classified elsewhere
M00.861Infection and inflammatory reaction due to internal joint prosthesis, initial encounter
T84.54XADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Knee Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T84.54XA.
Impact
Clinical: Ambiguity in treatment location., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify left or right knee., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Always use T84.54XA as the primary code for prosthetic joint infections.
Impact
Failure to sequence infection codes correctly can lead to audit flags.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Knee Infection
Use these documentation templates to ensure complete and accurate documentation for Knee Infection. These templates include all required elements for proper coding and billing.
Prosthetic Joint Infection
Specialty: OrthopedicsRequired Elements
- Infection confirmation
- Organism identification
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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