ICD-10 Coding for Osteoarthritis of the Right Knee(M17.11, M17.31)
Complete ICD-10-CM coding and documentation guide for Osteoarthritis of the 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 the Right Knee
M15-M19Primary Range
Osteoarthritis
This range includes all osteoarthritis codes, with M17.11 specifically for unilateral primary osteoarthritis of the right knee.
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 the patient has primary osteoarthritis in the right knee without a history of trauma. |
|
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | Use when osteoarthritis is due to a previous injury or surgery on the right knee. |
|
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 right knee
Essential facts and insights about Osteoarthritis of the Right Knee
Primary ICD-10-CM Codes for osteoarthritis right knee
Decision Criteria
clinical Criteria
- Presence of primary osteoarthritis symptoms without trauma history.
documentation Criteria
- Explicit mention of 'primary osteoarthritis' and 'right knee' in the medical record.
Applicable To
- Primary osteoarthritis of the right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- Morning stiffness <30 min
- Crepitus
- Bony enlargement
- Kellgren-Lawrence Grade ≥2 on X-ray
Code-Specific Risks
- Incorrectly coding as secondary osteoarthritis without evidence of underlying condition.
Coding Notes
- Ensure documentation specifies 'primary' and 'right knee' to avoid unspecified coding.
M17.31 - Unilateral post-traumatic osteoarthritis, right knee
Use when osteoarthritis is due to a previous injury or surgery on the right knee.
Applicable To
- Post-traumatic osteoarthritis of the right knee
Excludes
- Primary osteoarthritis (M17.11)
Clinical Validation Requirements
- History of trauma or surgery
- Instability on exam
- MRI showing chondral loss
Coding Notes
Document the injury history clearly to support post-traumatic coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in right knee
M25.561Differential 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 the 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 denied claims due to incomplete coding.
Mitigation Strategy
Always document the underlying condition when coding secondary OA., Use templates to ensure all necessary information is captured.
Impact
Reimbursement: May lead to reduced reimbursement due to unspecified coding., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure 'primary OA' and 'right knee' are in the same sentence.
Impact
Using unspecified codes when specific laterality and type are documented.
Mitigation Strategy
Implement documentation checks to ensure specificity.
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 the Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Osteoarthritis of the Right Knee
Use these documentation templates to ensure complete and accurate documentation for Osteoarthritis of the Right Knee. These templates include all required elements for proper coding and billing.
Orthopedic assessment for primary OA
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination
- Imaging results
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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