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M17.11 ICD-10 Code - Easy Guide to Unilateral Primary Osteoarthritis of the Right Knee

Name: Cures Medical Billing Services Company
Address: 3811 Ditmars Blvd# 1124, Astoria, NY 11105, Astoria, NY, 11105, USA
Telephone: +1 (917) 994-9941

The M17.11 ICD-10 code is used to describe primary osteoarthritis (OA) in the right knee, a joint problem that happens when the cartilage wears down over time. This condition leads to bone friction, inflammation, and progressive symptoms:

Pain(worsens with activity)
Stiffness(especially morning stiffness >30 minutes)
Swelling(due to synovitis or effusion)
Reduced mobility(limited flexion/extension)

Diagnostic Criteria

Physical Exam: Crepitus, joint tenderness, bony enlargement.
Imaging:
- X-ray: Combined space contraction, osteophytes, subchondral sclerosis.
- MRI: Cartilage loss, synovial thickening (used for early-stage detection).
Lab Tests: Rule out inflammatory arthritis (normal ESR/CRP in primary OA).

Risk Factors

Age (>50 years)
Obesity (BMI ≥30 increases knee load by 4x)
Genetics (COL2A1 gene mutations)
Prior trauma (e.g., ACL tears, meniscus injuries)

Management & Treatment Pathways

Conservative Approaches

Weight Loss: 10% body weight reduction lowers symptom progression by 50%.
Physical Therapy: Quadriceps strengthening, low-impact exercises (swimming, cycling).
Pharmacotherapy:
- NSAIDs (e.g., ibuprofen) for pain/inflammation.
- Intra-articular corticosteroid injections (3–4 doses/year).
Assistive Devices: Knee braces (unloaded-type), canes.

Surgical Interventions

Arthroscopy: Debridement for mechanical symptoms (locking/catching).
Osteotomy: Realigns bone for younger patients with localized damage.
Total Knee Replacement (TKR): For end-stage OA (85% 10-year survival rate).

ICD-10 Coding Guidelines & Pitfalls

Specificity Matters

11: Right knee only.
12: Left knee OA.
31: Post-traumatic OA, right knee (distinct etiology).

Common Errors

Using 9(undetermined OA) without detailing laterality.
Confusing primary OA (M17.1-)with secondary OA (M17.5-) from trauma or obesity.

ICD-11 Transition

In ICD-11, new codes like FA01.0 (primary OA of the knee) and FA01.1 (secondary OA) are used, along with extra details like bone alignment issues (such as varus or valgus deformities).

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Related Codes & Crosswalks

ICD-10 Code	Description	ICD-9 Equivalent
M17.11	Primary OA, right knee	715.16
M17.12	Primary OA, left knee	715.26
M17.31	Support-painful OA, right knee	715.36
M17.0	Bilateral primary OA	715.06

Bilateral vs. Unilateral

Use 0only if both knees are confirmed affected.
For self-leading cases, incessantly specify laterality (M17.11/M17.12).

Coding Best Practices

Documentation:
- Specify “primary” vs “post-traumatic” OA.
- Note laterality (avoid “unspecified knee” codes).
Billing Compliance:
- Link M17.11 to CPT codes like 73564(knee X-ray) or 20610 (joint injection).
Audit-Proofing:
- Use EHR templates with auto-populated laterality fields.

How Care patron Simplifies M17.11 Coding

Care patrons’ ICD-10 coding app enhances accuracy with:
- Real-Time Updates: Automatically integrates 2024 CMS coding changes.
- Cross-Referencing: Instantly pull related codes (e.g., M17.31 vs. M17.11).
- Billing Combination: Decreases claim denials by fading mismatched codes.
- Patient Portals: Track OA progression (pain scales, mobility logs) for audit trails.

Frequently Asked Questions (FAQs)

Can M17.11 be used for bilateral knee OA?

No—bilateral cases require M17.0.

What’s the ICD-10 code for right knee pain without OA?

Use M25.561 (pain in right knee) if OA isn’t confirmed.

How does ICD-11 improve OA coding?

Adds severity grades (mild/moderate/severe) and biomechanical alignment data.

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