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ICD-10 Guide
DiagnosesRight Knee Joint Pain

Right Knee Joint Pain

ICD-10 Coding for Right Knee Joint 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 Joint Pain?
Essential facts and insights about Right Knee Joint 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 osteophytes.
  • Tenderness on palpation, crepitus during movement, and positive McMurray's test.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history, physical examination findings, imaging results, and treatment plan.
  • Use of specific terms like 'osteoarthritis', 'meniscus tear', or 'ligament injury'.
  • Example: 'Patient presents with right knee pain, MRI shows a meniscus tear.'

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for specificity in coding knee conditions.
  • Common errors include using unspecified codes or failing to document the laterality.

Code Exclusions

Important Exclusions

  • Fractures, infections, and systemic diseases affecting the knee.
  • Alternative codes for left knee conditions or unspecified knee pain.

Related ICD-10 Codes

Primary Codes
M17.11
Unilateral primary osteoarthritis, right knee
M23.21
Derangement of meniscus due to old tear or injury, right knee
S83.211A
Tear of medial meniscus, right knee, initial encounter
Ancillary Codes
G89.29
M25.561
.
Differential Codes
M17.11
M25.561

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Adults with knee pain, athletes with sports injuries, and elderly patients with degenerative conditions.
  • Orthopedic clinics, urgent care centers, and primary care settings.

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 history, physical exam findings, and imaging results.

Billing considerations?

Ensure correct ICD-10 codes are used to reflect the diagnosis accurately.