ICD-10 Coding for Primary Osteoarthritis of the Right Knee(M17.11)
Complete ICD-10-CM coding and documentation guide for Primary 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 Primary Osteoarthritis of the Right Knee
M15-M19Primary Range
Osteoarthritis
This range includes all types of osteoarthritis, with M17.11 specifically for unilateral primary osteoarthritis of the right knee.
Key Information: ICD-10 code for primary osteoarthritis right knee
Essential facts and insights about Primary Osteoarthritis of the Right Knee
Primary ICD-10-CM Code for primary osteoarthritis right knee
Decision Criteria
clinical Criteria
- X-ray findings of osteoarthritis in the right knee
documentation Criteria
- Explicit mention of 'primary osteoarthritis' and 'right knee'
Applicable To
- Primary osteoarthritis of the right knee
Clinical Validation Requirements
- X-ray showing joint space narrowing, osteophytes, or subchondral sclerosis
- Clinical documentation specifying 'primary' and 'right knee'
Code-Specific Risks
- Risk of using unspecified codes like M17.10 when laterality is known.
Coding Notes
- Ensure documentation specifies 'primary' and 'right knee' to avoid unspecified codes.
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 Primary 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: Leads to incorrect diagnosis coding., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Educate providers on documentation specificity., Use templates that prompt for necessary details.
Impact
Reimbursement: May lead to claim denials or reduced payments., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases the accuracy of patient records.
Mitigation Strategy
Always specify the laterality and type of osteoarthritis.
Impact
Use of unspecified codes when laterality is documented.
Mitigation Strategy
Implement regular audits and provider education.
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 Primary Osteoarthritis of the Right Knee, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Primary Osteoarthritis of the Right Knee
Use these documentation templates to ensure complete and accurate documentation for Primary Osteoarthritis of the Right Knee. These templates include all required elements for proper coding and billing.
Chronic right knee pain due to osteoarthritis
Specialty: OrthopedicsRequired Elements
- Subjective: Patient reports chronic right knee pain.
- Objective: X-ray findings, ROM, and physical exam details.
- Assessment: Diagnosis of primary osteoarthritis, right knee.
- Plan: Treatment plan including medications and physical therapy.
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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