When documenting right knee osteoarthritis, the appropriate ICD-10 code to use is M17.11. It specifically identifies primary osteoarthritis in the right knee. It specifically refers to unilateral primary osteoarthritis of the right knee a common but often misunderstood musculoskeletal condition seen in elderly patients, athletes, and those with a history of joint injury.
As a medical billing provider or clinician, accuracy here is important not only for reimbursement compliance but also for improving patient care outcomes and reducing audit risks.
The M17.11 ICD-10 code stands for:
Unilateral Primary Osteoarthritis – Right Knee
It is categorized under:
Major osteoarthritis of the right knee is a chronic, deteriorating joint condition. This ICD code covers wear-and-tear arthritis localized only in the right knee and not caused by trauma or general disease.
These match with diagnostic coding criteria and help avoid misclassification like M17.9 (unspecified knee OA).
In clinics, the following tools support coding accuracy:
Tip from experience: Always document laterality and specify whether it’s primary vs. post-traumatic.
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).
ICD-10 Code | Description | ICD-9 Equivalent |
M17.11 | Primary OA, right knee | 715.16 |
M17.12 | Primary OA, left knee | 715.26 |
M17.0 | Bilateral OA | 715.06 |
M17.31 | Post-traumatic OA, right knee | 715.36 |
If both knees are affected, use M17.0. If only the left side is involved, switch to left knee osteoarthritis ICD 10 — M17.12.
The ICD-11 version introduces better specificity:
It may also include standard deformities like varus/valgus misalignments, important for orthopedic referrals.
Billing tip: Begin training teams now on ICD-11 codes to ensure seamless migration when your EHR updates.
Top Billing Errors to Avoid:
Coding Best Practices:
At Cures Medical Billing, we work with clinics and orthopedic specialists to ensure precision:
One orthopedic client had a 12% denial rate on knee OA claims due to “unspecified laterality” coding. After switching to a structured documentation workflow and accurate use of M17.11, their denial rate dropped to under 2%, translating to over $12,000/month in recovered revenue.
With coding standards evolving and payer scrutiny increasing, it’s no longer enough to just “guess” at the right ICD code. The M17.11 ICD-10 code may seem simple, but its proper use affects your revenue, compliance, and patient outcomes.
As healthcare providers and billing experts, staying ahead of these nuances is how we protect your bottom line and improve patient trust.
Need help getting it right? Learn more about our medical Billing Services and Medical Coding Services designed for orthopedic and primary care clinics.
The M17.11 ICD code describes primary osteoarthritis of the right knee, a common joint degeneration condition due to aging or wear-and-tear.
Usage M17.11 for age-correlated right knee OA without strain history. M17.31 is for post-traumatic osteoarthritis after injury or surgery.
M17.11 applies solely to osteoarthritis in the right knee. If both knees are affected and clinically confirmed, M17.0 should be used to report bilateral primary OA.
CPT codes such as 73564 for knee imaging and 20610 for joint injections are commonly billed alongside M17.11 when evaluating or treating right knee osteoarthritis.
Yes. In ICD-11, FA01.0 refers to primary osteoarthritis of the knee. It offers more detail, including bone deformities like virus or valgus.
Discover Cures Medical Billing Services Across Different States
FL
NY
ML
CO
NJ
AZ
TX
CA
WA
We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.
Medical billing around Astoria, NY, and beyond is our core competency and our specialists will efficiently manage all your billing needs. Our medical billing specialists have over 12 Plus years of experience with all security technologies to ensure data integrity for our customers. Using our medical billing service, anyone can make their medical billing task less resource-consuming.
Discover unparalleled efficiency and precision in healthcare financial management with Cures Medical Billing Solutions.
© 2024 Created Cures Medical Billing Solutions, All copyrights Reserved
