ICD-10 Coding for Osteoarthritis of Right Knee(M17.11, M17.31)
Complete ICD-10-CM coding and documentation guide for Osteoarthritis of Right Knee. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Osteoarthritis of Right Knee
M15-M19Primary Range
Arthritis and Arthropathies
This range includes all types of osteoarthritis, with specific codes for primary, secondary, and post-traumatic osteoarthritis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when osteoarthritis is due to age-related degeneration without a history of trauma. |
|
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | Use when osteoarthritis is directly linked to a previous traumatic event. |
|
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 osteoarthritis of right knee
Essential facts and insights about Osteoarthritis of Right Knee
Primary ICD-10-CM Codes for osteoarthritis of right knee
Decision Criteria
clinical Criteria
- X-ray findings consistent with osteoarthritis
documentation Criteria
- Documentation must specify 'primary osteoarthritis' and 'right knee'
Applicable To
- Degenerative joint disease of right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- X-ray showing joint space narrowing and osteophytes
- Clinical symptoms such as pain and crepitus
Code-Specific Risks
- Risk of using unspecified codes when laterality is known
Coding Notes
- Ensure documentation specifies laterality and type of osteoarthritis.
M17.31 - Unilateral post-traumatic osteoarthritis, right knee
Use when osteoarthritis is directly linked to a previous traumatic event.
Applicable To
- Post-traumatic degenerative joint disease of right knee
Excludes
- Primary osteoarthritis (M17.11)
Clinical Validation Requirements
- History of trauma such as fracture or ligament injury
- Imaging showing degenerative changes post-injury
Coding Notes
Document the specific trauma and date if available.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Morbid obesity
E66.01Differential 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 Osteoarthritis of Right Knee 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: Non-compliance with coding guidelines., Financial: Potential for claim denials.
Mitigation Strategy
Educate providers on documentation requirements, Use templates that prompt for specific details
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify the laterality in the documentation and use the appropriate code.
Impact
Using M17.9 when laterality is known can trigger audits.
Mitigation Strategy
Ensure documentation specifies laterality and type.
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 Osteoarthritis of Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Osteoarthritis of Right Knee
Use these documentation templates to ensure complete and accurate documentation for Osteoarthritis of Right Knee. These templates include all required elements for proper coding and billing.
Chronic knee pain with imaging confirmation
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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