ICD-10 Knee Pain Code Guide
One of the most injury prone areas of the body is the knee. Whether through sport, normal activity, or advancing age, knee pain and injury inflicts the majority of individuals throughout their lifetime. Most treatment for knee pain or injury is conducted in collaboration between physicians and physical therapists because each play such a significant role in making sure that their patients knees are functioning properly and that they are able to move through life without pain.
In this next ICD-10 code guide from PatientStudio, we are going to consider many of the most common knee injuries, why they arise, how they are commonly treated, and most importantly give you a comprehensive list of the ICD-10 codes that are used in their treatment.
Anterior Cruciate Ligament (ACL) Injury
Usually, anterior cruciate ligament injuries are caused by tears or sprains of the ligament (ACL). The ACL is a ligament that connects the thighbone (femur) to the shinbone (tibia) in the knee joint and helps stabilize it. The most common type of knee injury occurs during sports activities that involve sudden stops and changes of direction, jumping, and landing, such as soccer, basketball, football, and downhill skiing. One of the main symptoms of this condition is a loud "pop" or "popping" sensation in the knee. Aside from loss of full range of motion, swelling, tenderness along the joint line, discomfort when walking, and inability to continue activities are other symptoms. An examination of all the structures of the injured knee will be conducted to diagnose this condition. A diagnostic imaging test, such as an X-ray or magnetic resonance imaging (MRI), may also be performed. Rest, bracing, physical therapy, and rehabilitation exercises can be used to regain strength and stability after a ruptured ACL, depending on the severity of the injury. The anterior cruciate ligament can be rebuilt surgically in severe cases.
Injuries to the ACL are coded in ICD-10 as follows –
S83.51 Sprain of anterior cruciate ligament of knee
S83.511 Sprain of anterior cruciate ligament of right knee
S83.511A …… initial encounter
S83.511D …… subsequent encounter
S83.511S …… sequela
S83.512 Sprain of anterior cruciate ligament of left knee
S83.512A …… initial encounter
S83.512D …… subsequent encounter
S83.512S …… sequela
S83.519 Sprain of anterior cruciate ligament of unspecified knee
S83.519A …… initial encounter
S83.519D …… subsequent encounter
S83.519S …… sequela
Iliotibial Band Syndrome
A common cause of lateral knee pain in runners and cyclists, iliotibial band syndrome (ITBS) is an overuse injury to the connective tissues located on the side of the thighs and knees. There is pain and tenderness in the region, especially above the knee joint, as a result of this condition. The IT band is typically overly tight and rubs against each bone, causing ITBS, an overuse injury from repetitive movements. One of the most common symptoms of this condition is chronic pain on the lateral side of the knee. An evaluation of the medical history and a physical examination are used to diagnose IT band syndrome. Certain types of body assessments may be performed by physicians or physical therapists by requiring patients to perform certain exercises to demonstrate movement patterns, strength, and stability. A pelvic alignment assessment and IT band tightness assessment may be conducted. MRI scans, ultrasounds, X-rays, and other diagnostic imaging tests may also be conducted in some cases. There are a number of options available for treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs), icing, stretching, and strengthening exercises generally performed within the physical therapy setting as well as at home.
ITBS related ICD-10 codes include –
M76.3 Iliotibial band syndrome
M76.30 Iliotibial band syndrome, unspecified leg
M76.31 Iliotibial band syndrome, right leg
M76.32 Iliotibial band syndrome, left leg
Meniscal Tear
Torn meniscus is a common knee injury that occurs when the cartilage tears. In the leg, the meniscus is a piece of cartilage that provides cushioning between the femur and tibia (shinbone). Whenever the knee joint is forced to twist or rotate forcefully, such as when exerting full weight, the meniscus tears. In general, a torn meniscus is diagnosed by moving the knees and legs in various directions during a physical examination. Additionally, this helps pinpoint the exact cause of symptoms and diagnose the extent of movement. The knee joint can become stiff and painful if the meniscus is torn and not treated. Occasionally, patients may experience difficulty extending their knees fully due to a block to knee motion. Depending on the type, size, and location of the tear, treatment for a torn meniscus may vary from person to person. A combination of rest, physical therapy, over-the-counter medications, and surgical procedures such as arthroscopy is used to treat the condition. Normally, patients are instructed to rest and avoid twisting, rotating, and pivoting their knees to avoid aggravating the pain. Orthopedists may recommend meniscus transplants or knee replacement surgeries for patients with advanced stages of the disease.
ICD-10 codes associated with meniscal tears:
S83.2 Tear of meniscus, current injury
S83.20 Tear of unspecified meniscus, current injury
S83.200 Bucket-handle tear of unspecified meniscus, current injury, right knee
S83.200A …… initial encounter
S83.200D …… subsequent encounter
S83.200S …… sequela
S83.201 Bucket-handle tear of unspecified meniscus, current injury, left knee
S83.201A …… initial encounter
S83.201D …… subsequent encounter
S83.201S …… sequela
S83.202 Bucket-handle tear of unspecified meniscus, current injury, unspecified knee
S83.202A …… initial encounter
S83.202D …… subsequent encounter
S83.202S …… sequela
S83.203 Other tear of unspecified meniscus, current injury, right knee
S83.203A …… initial encounter
S83.203D …… subsequent encounter
S83.203S …… sequela
S83.204 Other tear of unspecified meniscus, current injury, left knee
S83.204A …… initial encounter
S83.204D …… subsequent encounter
S83.204S …… sequela
S83.205 Other tear of unspecified meniscus, current injury, unspecified knee
S83.205A …… initial encounter
S83.205D …… subsequent encounter
S83.205S …… sequela
S83.206 Unspecified tear of unspecified meniscus, current injury, right knee
S83.206A …… initial encounter
S83.206D …… subsequent encounter
S83.206S …… sequela
S83.207 Unspecified tear of unspecified meniscus, current injury, left knee
S83.207A …… initial encounter
S83.207D …… subsequent encounter
S83.207S …… sequela
S83.209 Unspecified tear of unspecified meniscus, current injury, unspecified knee
S83.209A …… initial encounter
S83.209D …… subsequent encounter
S83.209S …… sequela
S83.21 Bucket-handle tear of medial meniscus, current injury
S83.211 Bucket-handle tear of medial meniscus, current injury, right knee
S83.211A …… initial encounter
S83.211D …… subsequent encounter
S83.211S …… sequela
S83.212 Bucket-handle tear of medial meniscus, current injury, left knee
S83.212A …… initial encounter
S83.212D …… subsequent encounter
S83.212S …… sequela
S83.219 Bucket-handle tear of medial meniscus, current injury, unspecified knee
S83.219A …… initial encounter
S83.219D …… subsequent encounter
S83.219S …… sequela
S83.22 Peripheral tear of medial meniscus, current injury
S83.221 Peripheral tear of medial meniscus, current injury, right knee
S83.221A …… initial encounter
S83.221D …… subsequent encounter
S83.221S …… sequela
S83.222 Peripheral tear of medial meniscus, current injury, left knee
S83.222A …… initial encounter
S83.222D …… subsequent encounter
S83.222S …… sequela
S83.229 Peripheral tear of medial meniscus, current injury, unspecified knee
S83.229A …… initial encounter
S83.229D …… subsequent encounter
S83.229S …… sequela
S83.23 Complex tear of medial meniscus, current injury
S83.231 Complex tear of medial meniscus, current injury, right knee
S83.231A …… initial encounter
S83.231D …… subsequent encounter
S83.231S …… sequela
S83.232 Complex tear of medial meniscus, current injury, left knee
S83.232A …… initial encounter
S83.232D …… subsequent encounter
S83.232S …… sequela
S83.239 Complex tear of medial meniscus, current injury, unspecified knee
S83.239A …… initial encounter
S83.239D …… subsequent encounter
S83.239S …… sequela
S83.24 Other tear of medial meniscus, current injury
S83.241 Other tear of medial meniscus, current injury, right knee
S83.241A …… initial encounter
S83.241D …… subsequent encounter
S83.241S …… sequela
S83.242 Other tear of medial meniscus, current injury, left knee
S83.242A …… initial encounter
S83.242D …… subsequent encounter
S83.242S …… sequela
S83.249 Other tear of medial meniscus, current injury, unspecified knee
S83.249A …… initial encounter
S83.249D …… subsequent encounter
S83.249S …… sequela
S83.25 Bucket-handle tear of lateral meniscus, current injury
S83.251 Bucket-handle tear of lateral meniscus, current injury, right knee
S83.251A …… initial encounter
S83.251D …… subsequent encounter
S83.251S …… sequela
S83.252 Bucket-handle tear of lateral meniscus, current injury, left knee
S83.252A …… initial encounter
S83.252D …… subsequent encounter
S83.252S …… sequela
S83.259 Bucket-handle tear of lateral meniscus, current injury, unspecified knee
S83.259A …… initial encounter
S83.259D …… subsequent encounter
S83.259S …… sequela
S83.26 Peripheral tear of lateral meniscus, current injury
S83.261 Peripheral tear of lateral meniscus, current injury, right knee
S83.261A …… initial encounter
S83.261D …… subsequent encounter
S83.261S …… sequela
S83.262 Peripheral tear of lateral meniscus, current injury, left knee
S83.262A …… initial encounter
S83.262D …… subsequent encounter
S83.262S …… sequela
S83.269 Peripheral tear of lateral meniscus, current injury, unspecified knee
S83.269A …… initial encounter
S83.269D …… subsequent encounter
S83.269S …… sequela
S83.27 Complex tear of lateral meniscus, current injury
S83.271 Complex tear of lateral meniscus, current injury, right knee
S83.271A …… initial encounter
S83.271D …… subsequent encounter
S83.271S …… sequela
S83.272 Complex tear of lateral meniscus, current injury, left knee
S83.272A …… initial encounter
S83.272D …… subsequent encounter
S83.272S …… sequela
S83.279 Complex tear of lateral meniscus, current injury, unspecified knee
S83.279A …… initial encounter
S83.279D …… subsequent encounter
S83.279S …… sequela
S83.28 Other tear of lateral meniscus, current injury
S83.281 Other tear of lateral meniscus, current injury, right knee
S83.281A …… initial encounter
S83.281D …… subsequent encounter
S83.281S …… sequela
S83.282 Other tear of lateral meniscus, current injury, left knee
S83.282A …… initial encounter
S83.282D …… subsequent encounter
S83.282S …… sequela
S83.289 Other tear of lateral meniscus, current injury, unspecified knee
S83.289A …… initial encounter
S83.289D …… subsequent encounter
S83.289S …… sequel
Osteoarthritis of the knee
The most common cause of osteoarthritis of the knee is aging. Most people will develop osteoarthritis at some point in their lives. Significant arthritis can develop at an earlier age due to several factors. Physical therapy or a doctor's examination will be the first step in diagnosing knee osteoarthritis. A medical history and any symptoms you may have will also be taken by your doctor. An MRI scan may be ordered when X-rays do not reveal a clear reason for joint pain or if the X-rays indicate damage to other types of joint tissue. Tests of the blood may be used to rule out other conditions that could be causing the pain, such as rheumatoid arthritis, a different type of arthritis caused by an immune system disorder. Knee osteoarthritis is primarily treated to relieve pain and restore mobility. Physical and occupational therapy, as well as weight loss and exercise, are usually part of the treatment plan. Your doctor can perform arthroscopy, osteotomy, or arthroplasty to treat osteoarthritis in the knee.
Common ICD-10 codes related to Osteoarthritis of the knee include:
M17 Osteoarthritis of knee
M17.0 Bilateral primary osteoarthritis of knee
M17.1 Unilateral primary osteoarthritis of knee
M17.10 Unilateral primary osteoarthritis, unspecified knee
M17.11 Unilateral primary osteoarthritis, right knee
M17.12 Unilateral primary osteoarthritis, left knee
M17.2 Bilateral post-traumatic osteoarthritis of knee
M17.3 Unilateral post-traumatic osteoarthritis of knee
M17.30 Unilateral post-traumatic osteoarthritis, unspecified knee
M17.31 Unilateral post-traumatic osteoarthritis, right knee
M17.32 Unilateral post-traumatic osteoarthritis, left knee
M17.4 Other bilateral secondary osteoarthritis of knee
M17.5 Other unilateral secondary osteoarthritis of knee
M17.9 Osteoarthritis of knee, unspecified
Patellofemoral (Kneecap) Pain
An injury to the front of the knee, around the kneecap (patella), is known as patellofemoral pain syndrome (PFPS). The condition more commonly called runner's knee is more frequently observed among those who participate in exercises involving jumping and running. It is important to note, however, that PFPS can also affect non-athletes. The front of the knee is usually affected by a dull, aching pain. Kneeling down, sitting for long periods of time, climbing stairs, squatting, and doing other normal daily activities can be extremely difficult with this condition because of the severe pain and stiffness that results. Factors causing the pain condition are unknown. There are, however, several factors that may contribute to the development of this condition, including muscle imbalances or weaknesses, overuse (from vigorous athletics or training), problems with the alignment of the kneecap, and prior knee surgeries. Resting the knee as much as possible and applying ice to the knee area are usually the first steps in treating this condition. Additionally, medications, physical therapy exercises, and braces can be recommended. When non-surgical treatments do not work, physicians may recommend surgical procedures like arthroscopy and realignment (realigning the angle of the knee cap or relieving pressure on the cartilage).
PFPS is diagnosed with the following ICD-10 codes:
M22 – Disorder of patella
M22.0 – Recurrent dislocation of patella
M22.00 – Recurrent dislocation of patella, unspecified knee
M22.01 – Recurrent dislocation of patella, right knee
M22.02 – Recurrent dislocation of patella, left knee
M22.1 – Recurrent subluxation of patella
M22.10 – Recurrent subluxation of patella, unspecified knee
M22.11 – Recurrent subluxation of patella, right knee
M22.12 – Recurrent subluxation of patella, left knee