ICD-10 Coding for Knee Joint Osteoarthritis(M17.0, M17.11)
Complete ICD-10-CM coding and documentation guide for Knee Joint Osteoarthritis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Knee Joint Osteoarthritis
M17.0-M17.9Primary Range
Osteoarthritis of the knee
This range covers all types of knee osteoarthritis, including primary, secondary, and post-traumatic forms.
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 bilateral knee osteoarthritis
Essential facts and insights about Knee Joint Osteoarthritis
Primary ICD-10-CM Codes for knee joint osteoarthritis
Decision Criteria
clinical Criteria
- Bilateral knee pain with radiographic confirmation
Applicable To
- Bilateral knee osteoarthritis
Excludes
- Post-traumatic osteoarthritis (M17.3x)
Clinical Validation Requirements
- Radiographic evidence of bilateral joint space narrowing
- Presence of osteophytes
Code-Specific Risks
- Ensure bilateral involvement is documented.
Coding Notes
- Ensure documentation specifies bilateral involvement.
M17.11 - Unilateral primary osteoarthritis, right knee
Use when only the right knee is affected by primary osteoarthritis.
Applicable To
- Primary osteoarthritis of the right knee
Excludes
- Post-traumatic osteoarthritis (M17.3x)
Clinical Validation Requirements
- Radiographic evidence of joint space narrowing in the right knee
- Symptoms of morning stiffness and crepitus
Coding Notes
Document specific symptoms and radiographic findings.
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 Knee Joint Osteoarthritis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.0.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential denial of claims.
Mitigation Strategy
Ensure radiographic evidence is included in the medical record.
Impact
Reimbursement: May lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify laterality if documented.
Impact
Using unspecified codes when laterality is documented.
Mitigation Strategy
Always document and code the specific knee affected.
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 Joint Osteoarthritis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Knee Joint Osteoarthritis
Use these documentation templates to ensure complete and accurate documentation for Knee Joint Osteoarthritis. These templates include all required elements for proper coding and billing.
Chronic knee pain management
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Radiographic evidence
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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