ICD-10 Coding for Left Knee Arthroplasty(M17.12, Z96.652)
Complete ICD-10-CM coding and documentation guide for Left Knee Arthroplasty. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Knee Arthroplasty
M17.0-M17.9Primary Range
Osteoarthritis of the knee
Primary diagnosis codes for knee osteoarthritis leading to arthroplasty.
Periprosthetic fracture around internal prosthetic joint
Used for complications related to knee arthroplasty.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M17.12 | Unilateral primary osteoarthritis, left knee | Use when the primary reason for arthroplasty is osteoarthritis in the left knee. |
|
| Z96.652 | Presence of left artificial knee joint | Use to indicate the status of a left knee replacement post-surgery. |
|
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 left knee arthroplasty
Essential facts and insights about Left Knee Arthroplasty
Primary ICD-10-CM Codes for left knee arthroplasty
Decision Criteria
clinical Criteria
- Radiographic evidence of osteoarthritis
documentation Criteria
- Detailed history of conservative treatment failure
Applicable To
- Primary osteoarthritis of the left knee
Excludes
- Bilateral primary osteoarthritis (M17.0)
Clinical Validation Requirements
- Radiographic evidence of osteoarthritis
- Clinical documentation of pain and functional limitation
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is correctly documented to avoid unspecified coding.
Z96.652 - Presence of left artificial knee joint
Use to indicate the status of a left knee replacement post-surgery.
Applicable To
- Status post left knee arthroplasty
Excludes
- Presence of unspecified artificial knee joint (Z96.659)
Clinical Validation Requirements
- Surgical history confirming knee replacement
Coding Notes
Ensure this code is sequenced after the primary diagnosis code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of left artificial knee joint
Z96.652Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Unilateral primary osteoarthritis, right knee
M17.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Knee Arthroplasty to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.12.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify left or right in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always document and code the specific laterality, such as Z96.652 for the left knee.
Impact
Lack of documentation for failed conservative treatments.
Mitigation Strategy
Implement checklist for documenting treatment history.
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 Left Knee Arthroplasty, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Knee Arthroplasty
Use these documentation templates to ensure complete and accurate documentation for Left Knee Arthroplasty. These templates include all required elements for proper coding and billing.
Left knee arthroplasty due to osteoarthritis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Conservative treatment history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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