ICD-10 Coding for Total Knee Replacement, Left(Z96.652, M17.12)
Complete ICD-10-CM coding and documentation guide for Total Knee Replacement, Left. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Total Knee Replacement, Left
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z96.652 | Presence of left artificial knee joint | Use for patients with a history of left knee replacement beyond the global period. |
|
| M17.12 | Unilateral primary osteoarthritis, left knee | Use to document the underlying condition leading to knee replacement. |
|
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 total knee replacement
Essential facts and insights about Total Knee Replacement, Left
Primary ICD-10-CM Codes for total knee replacement left
Decision Criteria
clinical Criteria
- Patient has a documented history of left knee replacement.
coding Criteria
- Use Z96.652 for follow-up visits beyond the global period.
Applicable To
- Status post left total knee arthroplasty
Excludes
- Aftercare following joint replacement (Z47.1)
Clinical Validation Requirements
- Documented history of left knee replacement
- Radiographic evidence of prosthesis
Code-Specific Risks
- Incorrect use for immediate post-op care
Coding Notes
- Ensure documentation specifies the left knee and the status of the joint replacement.
M17.12 - Unilateral primary osteoarthritis, left knee
Use to document the underlying condition leading to knee replacement.
Applicable To
- Degenerative joint disease of left knee
Excludes
- Bilateral primary osteoarthritis of knee (M17.0)
Clinical Validation Requirements
- Radiographic evidence of osteoarthritis
- Clinical symptoms such as pain and limited range of motion
Coding Notes
Ensure documentation supports the diagnosis of unilateral osteoarthritis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unilateral primary osteoarthritis, left knee
M17.12Differential 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 Total Knee Replacement, Left to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z96.652.
Impact
Clinical: Lack of evidence for severity of osteoarthritis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Ensure radiographic findings are documented in the patient's record.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use Z96.652 for visits beyond the 90-day global period.
Impact
Incorrect coding for visits within the global period.
Mitigation Strategy
Verify surgery dates and use appropriate codes.
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 Total Knee Replacement, Left, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Total Knee Replacement, Left
Use these documentation templates to ensure complete and accurate documentation for Total Knee Replacement, Left. These templates include all required elements for proper coding and billing.
Pre-operative evaluation for left TKA
Specialty: OrthopedicsRequired Elements
- Patient history of knee pain
- Failed conservative treatments
- Radiographic findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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