ICD-10 Coding for Left Knee Patellofemoral Syndrome(M22.2X2, M25.562)
Complete ICD-10-CM coding and documentation guide for Left Knee Patellofemoral Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Knee Patellofemoral Syndrome
M22.2X-M22.2X9Primary Range
Patellofemoral disorders
This range includes specific codes for patellofemoral disorders, including those affecting the left knee.
Pain in joint
This range includes codes for joint pain, which may be used when the specific cause is not identified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M22.2X2 | Patellofemoral disorders, left knee | Use when patellofemoral syndrome is confirmed with specific clinical findings. |
|
| M25.562 | Pain in left knee | Use when knee pain is present but specific etiology like patellofemoral syndrome is not confirmed. |
|
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 knee patellofemoral syndrome
Essential facts and insights about Left Knee Patellofemoral Syndrome
Primary ICD-10-CM Codes for left knee patellofemoral syndrome
Decision Criteria
clinical Criteria
- Presence of retropatellar pain with specific aggravating activities
documentation Criteria
- Detailed physical exam findings and imaging results
Applicable To
- Retropatellar pain
- Patellar maltracking
Clinical Validation Requirements
- Retropatellar pain exacerbated by activities like squatting or stair descent
- Physical exam findings such as patellar tilt or tenderness
- Imaging to rule out other knee pathologies
Code-Specific Risks
- Using this code without confirming patellofemoral syndrome can lead to denials.
Coding Notes
- Ensure documentation specifies the left knee and includes detailed clinical findings.
M25.562 - Pain in left knee
Use when knee pain is present but specific etiology like patellofemoral syndrome is not confirmed.
Applicable To
- Generalized knee pain
Excludes
- Specific knee disorders like patellofemoral syndrome (M22.2X2)
Clinical Validation Requirements
- Absence of specific structural findings
- No confirmation of patellofemoral syndrome
Coding Notes
Use this code for non-specific knee pain when further diagnostic workup is pending.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
High school as place of occurrence
Y92.213Differential 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 Left Knee Patellofemoral Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.2X2.
Impact
Clinical: Leads to ambiguity in treatment plans., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for claim denials due to incomplete documentation.
Mitigation Strategy
Always specify left or right in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: May result in lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure clinical documentation supports the use of M22.2X2 by confirming patellofemoral syndrome.
Impact
Using non-specific codes when a specific diagnosis is confirmed.
Mitigation Strategy
Ensure documentation supports the use of specific codes like M22.2X2.
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 Left Knee Patellofemoral Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Knee Patellofemoral Syndrome
Use these documentation templates to ensure complete and accurate documentation for Left Knee Patellofemoral Syndrome. These templates include all required elements for proper coding and billing.
Orthopedic Evaluation for Knee Pain
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Differential diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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