ICD 10 Code for Knee Pain and guidelines:
ICD 10 Code for Knee Pain | ICD 10 Code for Knee Pain – Description |
M25.561 | ICD 10 code for Right knee pain |
M25.562 | ICD 10 code for Left knee pain |
M25.569 | ICD 10 code for Unspecified knee pain |
Urgent advice: Get advice from 111 now if:
There are three ways to approach knee pain diagnosis:
The most common knee injuries include the following:
Taking care of yourself when you have a swollen knee includes:
M25. 561 Pain in right knee - ICD-10-CM Diagnosis Codes.
Pain in unspecified kneeM25. 569 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.The 2022 edition of ICD-10-CM M25. 569 became effective on October 1, 2021.This is the American ICD-10-CM version of M25. 569 - other international versions of ICD-10 M25.
Code M25. 50 is the diagnosis code used for Pain in the Unspecified Joint. It falls under the category of Diseases of the musculoskeletal system and connective tissue.
There is no bilateral code for knee pain in ICD-10-CM; therefore, two codes are necessary to indicate both knees are affected. The fact that the knee pain is chronic is not addressed in the codes for knee pain. Codes in category G89 in ICD-10-CM are for Pain, not elsewhere classified, including acute and chronic pain.
ICD-10 code M25. 569 for Pain in unspecified knee is a medical classification as listed by WHO under the range - Arthropathies .
M25. 569 - Pain in unspecified knee. ICD-10-CM.
606.
ICD-10 code M79. 604 for Pain in right leg is a medical classification as listed by WHO under the range - Soft tissue disorders .
Bilateral knee pain is the name for pain in both of a person's knees. Bilateral knee pain is usually the result of arthritis. Different forms of arthritis, including osteoarthritis and gout, can cause this issue. Swelling, joint stiffness, and mobility issues can all present alongside bilateral knee pain.
ICD-10 Code for Bilateral primary osteoarthritis of knee- M17. 0- Codify by AAPC.
Knee pain can be mild, moderate or severe. The reasons for pain can vary such as injury, overuse, infection and inflammation. Sometimes there may be swelling and redness depends on the cause. We need to visit doctor as per the severity and as per how long the pain lasts.
There may be need of radiological tests (X-ray, CT, MRI, ultrasound) or arthrocentesis (lab analysis of knee joint fluid) for further evaluation to check for infections or injury to tendon or ligament.
Knee is one of the biggest joint in body which joints thigh bone (femur) and lower leg joint (tibia). The knee cap is called patella. Tendons (flexible connective tissue) and ligaments (inelastic collagen tissue) help joining these bones and make the knee joint.
Knee pain is a symptom; hence follow ICD coding guideline of not coding signs and symptoms when there is a definitive diagnosis made.
Review the entire medical record thoroughly especially physical examination to determine the correct anatomical site of pain. Do not code unspecified knee pain if there is any site specification mentioned in the record.
Hoffa’s syndrome is not coded as it is mentioned as “possible”.
Codes for chronic or recurrent bone, joint, or muscle conditions are located in Chapter 13 of the ICD-10-CM manual. For example, code M22.11 is used to report recurrent subluxation of the right patella.
Codes for acute musculoskeletal injuries are located in Chapter 19 of ICD-10-CM. For example, ICD-10-CM code S83.251A is used to report an initial encounter for a bucket-handle tear of lateral meniscus of the right knee.
The ICD-10-CM Index indicates that pain NOS is reported with code R52 (Pain, unspecified). However, reimbursement for this vague code is likely to be problematic, so try to obtain a more specific diagnosis whenever possible.
You must code flank pain as unspecified abdominal pain (R10.9) unless the physician provides additional information about the location of the pain, such as whether it is in the upper or lower portion of the abdomen. Pelvic pain is classified to code R10.2 (Pelvic and perineal pain).
For example, you can assign a G89 code to indicate that the pain is acute or chronic. You should assign the site-specific pain code first unless the purpose of the encounter is pain management, in which case the G89 code is first. For example, a patient is referred for ankle x-rays for chronic right ankle pain.
Pain that does not point to a specific body system is classified in the Symptoms and Signs chapter. For example, abdominal pain is classified to category R10. Certain specific types of pain are classified to category G89 (Pain, not elsewhere classified) in the Nervous System chapter.
Abdominal tenderness (R10.81-): Tenderness is abnormal sensitivity to touch. While pain is a symptom that the patient reports, tenderness is a reaction that the physician observes while examining the patient’s abdomen.
Chest pain on breathing (R07.1): This type of pain can be a sign of pulmonary embolism.
Pain that points to a disorder of a specific body system is classified in the body system chapters. For example, low back pain is classified in the Musculoskeletal chapter (M54.5) and testicular pain is classified in the Genitourinary System chapter (N50.8).