ICD-10 Coding for Right Knee Chondromalacia(M22.41, M94.261)
Complete ICD-10-CM coding and documentation guide for Right Knee Chondromalacia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Knee Chondromalacia
M22.4-M22.49Primary Range
Chondromalacia patellae
This range includes codes specific to chondromalacia affecting the patellar surface.
Chondromalacia of other parts of the knee
This range includes codes for chondromalacia affecting knee structures other than the patella.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M22.41 | Chondromalacia patellae, right knee | Use when chondromalacia is isolated to the patellar surface of the right knee. |
|
| M94.261 | Chondromalacia, right knee, other | Use when chondromalacia affects knee structures other than the patella. |
|
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 chondromalacia
Essential facts and insights about Right Knee Chondromalacia
Primary ICD-10-CM Codes for right knee chondromalacia
Decision Criteria
clinical Criteria
- MRI shows patellar cartilage softening
documentation Criteria
- Documentation specifies 'retropatellar' involvement
Applicable To
- Retropatellar cartilage softening
Excludes
- Chondromalacia of other knee structures (M94.261)
Clinical Validation Requirements
- MRI showing patellar cartilage softening
- Positive Clarke's test
Code-Specific Risks
- Misclassification if non-patellar involvement is present
Coding Notes
- Ensure documentation specifies patellar involvement to avoid incorrect coding.
M94.261 - Chondromalacia, right knee, other
Use when chondromalacia affects knee structures other than the patella.
Applicable To
- Chondromalacia of femoral condyle
Excludes
- Chondromalacia patellae (M22.41)
Clinical Validation Requirements
- MRI showing chondral lesion in femoral condyle
- Joint line tenderness
Coding Notes
Ensure exclusion of patellar involvement is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acquired absence of knee
Z89.52Differential 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 Chondromalacia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M22.41.
Impact
Clinical: Ambiguity in treatment planning, Regulatory: Non-compliance with coding standards, Financial: Claim rejections or delays
Mitigation Strategy
Always document laterality in clinical notes, Use templates that prompt for laterality
Impact
Reimbursement: Potential denial of claims due to incorrect coding, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Inaccurate clinical data affecting patient records
Mitigation Strategy
Verify documentation specifies patellar involvement.
Impact
Failure to specify laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory laterality fields in EHR systems.
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 Chondromalacia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Knee Chondromalacia
Use these documentation templates to ensure complete and accurate documentation for Right Knee Chondromalacia. These templates include all required elements for proper coding and billing.
Orthopedic Clinic Visit
Specialty: OrthopedicsRequired Elements
- Location: Right knee
- Onset: Duration of symptoms
- Character: Anterior vs. medial pain
- Aggravating factors: Stairs/sitting >30 mins
- Imaging: MRI findings
- Physical Exam: Clarke's test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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