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ICD-10 Guide
DiagnosesSwelling Right Knee

Swelling Right Knee

ICD-10 Coding for Swelling of Right Knee(M25.461, S83.011A)

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

Diagnosis Overview

What is Swelling Right Knee?
Essential facts and insights about Swelling of Right Knee

Key Clinical Considerations:

  • Localized swelling in the right knee joint
  • Pain and tenderness upon palpation
  • Limited range of motion
  • Joint warmth and redness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including onset and duration of swelling
  • Physical examination findings detailing swelling and range of motion
  • Results of imaging studies (e.g., X-rays, MRI) if performed

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use M25.461 for isolated swelling; consider additional codes for underlying conditions.
  • Common errors: Failing to specify laterality or not documenting the cause of swelling.

Code Exclusions

Important Exclusions

  • Fractures or dislocations of the knee
  • Infectious arthritis or gout

Related ICD-10 Codes

Primary Codes
M25.461
Swelling, right knee
Ancillary Codes
M17.9
M10.061
Differential Codes
M25.561
M25.461

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Adult and pediatric populations
  • Outpatient orthopedic clinics and emergency departments

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 any imaging results.

Billing considerations?

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