ICD-10 Coding for Patellofemoral Pain(M22.2X9, M22.41)
Complete ICD-10-CM coding and documentation guide for Patellofemoral Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Patellofemoral Pain
M22.2-M22.4Primary Range
Disorders of patella
This range includes specific disorders of the patella, including patellofemoral pain and chondromalacia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M22.2X9 | Patellofemoral disorders, unspecified knee | Use when patellofemoral pain is diagnosed without specific findings like chondromalacia. |
|
| M22.41 | Chondromalacia patellae, right knee | Use when chondromalacia is confirmed via imaging. |
|
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 patellofemoral pain
Essential facts and insights about Patellofemoral Pain
Primary ICD-10-CM Codes for patellofemoral pain
Decision Criteria
clinical Criteria
- Presence of anterior knee pain aggravated by activities like stair climbing.
Applicable To
- Patellofemoral pain syndrome
Excludes
- Chondromalacia patellae (M22.4)
Clinical Validation Requirements
- Pain reproduction on step-down test
- Positive Clarke's test
Code-Specific Risks
- Risk of using unspecified code when more specific diagnosis is available.
Coding Notes
- Ensure laterality is documented if known.
M22.41 - Chondromalacia patellae, right knee
Use when chondromalacia is confirmed via imaging.
Applicable To
- Chondromalacia of patella
Excludes
- Patellofemoral pain syndrome (M22.2X9)
Clinical Validation Requirements
- MRI or arthroscopy confirming cartilage damage
Coding Notes
Document specific knee affected.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other problems related to lifestyle
Z72.89Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Patellofemoral Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.2X9.
Impact
Clinical: May lead to incorrect diagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Include detailed patient history, Document specific activities that worsen pain
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Risk of non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation supports the most specific code available.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Ensure documentation supports the most specific code.
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 Patellofemoral Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Patellofemoral Pain
Use these documentation templates to ensure complete and accurate documentation for Patellofemoral Pain. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for patellofemoral pain
Specialty: OrthopedicsRequired Elements
- Subjective pain reports
- Objective measures like ROM and strength
- Assessment linking to specific codes
- Plan with interventions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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