Knee Pain ICD 10 coding Guidelines for coders

Since the introduction of ICD 10 codes, we are now focusing more on ICD 10 codes. Still in some region ICD 9, codes are used by medical coders. As we know, there is a lot of difference between ICD 9 and ICD 10 codes. The most important thing I like about ICD 10 codes is their specificity. For example, for knee pain ICD 9 code we used to use only 719.46, diagnosis code. However, the same ICD 9 code for knee pain when coded in ICD 10, we have three different ICD 10 codes for knee pain. And, this is one reason why we have many ICD 10 codes compared to ICD 9. Now, let us know more about this example of knee pain ICD 10 code.

 Knee Pain ICD 10 code

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ICD 10 codes for Knee pain 

Yes, we are now going to map this ICD 9 code, 719.46 for knee pain in ICD 10. Here, I will show how the code in ICD 10 gives more information about the anatomic location. As I said the there are three ICD 10 codes for knee pain which will differ only in their 6th digit. As I have already shared about coding unilateral & bilateral diagnosis in ICD 10, here also same rule follows. Below are the three ICD 10 codes for knee pain ICD 9 code.

Knee pain ICD 10 codes

M25.561 – Pain in right knee

M25.562 – Pain in left knee

M25.569 – Pain in unspecified knee

Now, as you can see above the sixth digit is only different in all the ICD 10 codes. Here, you can conclude that sixth digit 1 is for right side, 2 is for left side and 9 for unspecified side. This follows for all locations, which are present on both sides of the body. Hope, now you would have understood the difference between ICD 9 code and ICD 10 codes for knee pain.

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Patellofemoral pain syndrome ICD 9 code

Yes, this has been a very big issue for coders to code ICD 9 code for patellofemoral pain syndrome. The main cause for this diagnosis is knee pain. Hence, to code Patellofemoral pain syndrome you can use ICD 9 code of knee pain. It follows in the ICD 10 codes as well. However, do check if they are talking about patellofemoral pain associated with muscles or injuries, since the codes will differ in both ICD 9 can ICD 10 codes.

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Procedure performed for Knee pain ICD 10 code

Generally, the physician first always prefers to go for X-rays, if the patient codes with any joint pain. Here, also if a patient has knee pain diagnosis, then the physician mostly prefers blow X-ray exam for knee.

73560 Radiologic examination, knee; 1 or 2 views
73562 3 views
73564 complete, 4 or more views
73565 both knees, standing, anteroposterior
73580 Radiologic examination, knee, arthrography, radiological supervision and interpretation

These codes do not specify which views must be taken. Code 73560 reports one or two views only. Use 73562 to report three views and 73564 for a complete exam of the knee with a minimum of four views.

When a four-view X ray exam is performed solely to evaluate unilateral knee pathology, and the contralateral knee undergoes X rays for comparison purposes, the study may be reported with CPT code 73564. However, if the inclusion of the contralateral knee is specifically ordered for diagnostic purposes, CPT code 73560, Radiologic examination, knee; 1 or 2 views, may also be reported.

Physician many also perform MRI exam, if the patient comes with ICD 9 or ICD 10 codes for injuries of knee joint. This is mainly to find any traumatic sprain or tear present in the knee joint.

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