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v1.0.0
ICD-10 Guide
DiagnosesRight Knee Pain

Right Knee Pain

ICD-10 Coding for Right Knee Pain(M25.561, M17.11)

PRIMARY SPECIALTYOrthopedics
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Right Knee Pain?
Essential facts and insights about Right Knee Pain

Key Clinical Considerations:

  • Localized pain in the right knee, swelling, stiffness, and reduced range of motion.
  • MRI or X-ray findings indicating joint effusion, cartilage damage, or meniscal tears.
  • Tenderness on palpation, crepitus during movement, and positive McMurray's test.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including onset, duration, and nature of pain; previous treatments; and functional limitations.
  • Use of specific terms such as 'osteoarthritis', 'meniscus tear', or 'ligament injury'.
  • Examples include detailed descriptions of physical exam findings and imaging results.

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for specificity in coding to avoid denials.
  • Common errors include using unspecified codes or failing to document the cause of pain.

Code Exclusions

Important Exclusions

  • Fractures, dislocations, and other acute injuries not related to chronic knee pain.
  • Alternative codes for left knee conditions or unspecified knee pain.

Related ICD-10 Codes

Primary Codes
M17.11
Unilateral primary osteoarthritis, right knee
S83.211A
Tear of medial meniscus, right knee, initial encounter
M25.561
Pain in right knee
Ancillary Codes
G89.29
Differential Codes
M25.562
M25.569
M25.561
M25.561
if no osteoarthritis is confirmed.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Adults with knee injuries, osteoarthritis, or post-surgical conditions.
  • Orthopedic clinics, physical therapy centers, and urgent care facilities.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed patient history, physical exam findings, and imaging results.

Billing considerations?

Ensure accurate coding to reflect the specific diagnosis and any associated procedures.