ICD-10 Coding for Right Knee Degenerative Joint Disease(M17.11, M17.31)
Complete ICD-10-CM coding and documentation guide for Right Knee Degenerative Joint Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Knee Degenerative Joint Disease
M15-M19Primary Range
Osteoarthritis
This range includes all codes related to 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 |
|---|---|---|---|
| M17.11 | Unilateral primary osteoarthritis, right knee | Use when the patient has primary osteoarthritis of the right knee without a history of trauma. |
|
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | Use when osteoarthritis is secondary to a documented 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 right knee DJD
Essential facts and insights about Right Knee Degenerative Joint Disease
Primary ICD-10-CM Codes for right knee djd
Decision Criteria
clinical Criteria
- No history of trauma and X-ray evidence of osteoarthritis.
Applicable To
- Primary osteoarthritis of right knee
Excludes
- Post-traumatic osteoarthritis (M17.31)
Clinical Validation Requirements
- X-ray showing joint space narrowing
- Kellgren-Lawrence grade ≥2
Code-Specific Risks
- Misclassification if trauma history is not documented.
Coding Notes
- Ensure documentation specifies 'primary' and laterality.
M17.31 - Unilateral post-traumatic osteoarthritis, right knee
Use when osteoarthritis is secondary to a documented traumatic event.
Applicable To
- Post-traumatic osteoarthritis of right knee
Excludes
- Primary osteoarthritis (M17.11)
Clinical Validation Requirements
- Documented history of knee trauma
- Imaging showing osteoarthritis changes
Coding Notes
Ensure trauma history is documented with specific details.
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 Right Knee Degenerative Joint Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M17.11.
Impact
Clinical: Misdiagnosis of osteoarthritis type., Regulatory: Non-compliance with coding guidelines., Financial: Potential for incorrect billing.
Mitigation Strategy
Review patient history thoroughly, Document all relevant past injuries
Impact
Reimbursement: May result in lower DRG assignment., Compliance: Non-compliance with specificity requirements., Data Quality: Reduces data accuracy for clinical analysis.
Mitigation Strategy
Specify laterality and etiology to use M17.11 or M17.31.
Impact
Failure to specify laterality and etiology can lead to audits.
Mitigation Strategy
Ensure complete documentation of patient history and imaging.
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 Right Knee Degenerative Joint Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Knee Degenerative Joint Disease
Use these documentation templates to ensure complete and accurate documentation for Right Knee Degenerative Joint Disease. These templates include all required elements for proper coding and billing.
Primary Osteoarthritis Documentation
Specialty: OrthopedicsRequired Elements
- Patient history
- Imaging results
- Functional limitations
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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