ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM02.26

M02.26

Billable

Postimmunization arthropathy, knee

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 M02.26 is a billable code used to indicate a diagnosis of postimmunization arthropathy, knee.

Key Diagnostic Point:

Postimmunization arthropathy of the knee is a condition characterized by joint pain and inflammation following vaccination. The knee joint, a complex hinge joint formed by the femur, tibia, and patella, is susceptible to inflammatory responses due to its synovial membrane and surrounding soft tissues. The pathophysiology involves an autoimmune response triggered by the vaccine, leading to synovitis and potential cartilage damage. Clinically, patients may present with swelling, stiffness, and pain in the knee, often exacerbated by movement. Symptoms typically arise within days to weeks post-vaccination and may resolve spontaneously or require intervention. Understanding the anatomical structures involved, including ligaments, tendons, and the joint capsule, is crucial for accurate diagnosis and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of post-vaccination immune responses
  • Differentiation from other arthropathies
  • Documentation of onset timing related to vaccination
  • Assessment of joint involvement and functional limitations

Audit Risk Factors

  • Inadequate documentation of vaccination history
  • Failure to specify laterality of knee involvement
  • Misclassification with other arthropathies
  • Lack of evidence for functional limitations

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (e.g., X-rays, MRI) to assess joint integrity and functional assessments to evaluate range of motion and pain levels.

Common Clinical Scenarios

Patients may present with acute knee pain post-vaccination, requiring evaluation for potential surgical intervention if conservative measures fail.

Billing Considerations

Joint-specific considerations include assessing for effusion, ligament stability, and the impact of any pre-existing conditions.

Rheumatology

Documentation Requirements

Rheumatologic documentation should include laboratory tests for inflammatory markers (e.g., ESR, CRP) and assessments of disease activity to rule out underlying autoimmune disorders.

Common Clinical Scenarios

Patients may exhibit systemic symptoms alongside knee pain, necessitating a comprehensive evaluation for autoimmune conditions.

Billing Considerations

Consideration of systemic involvement and monitoring for potential progression of symptoms is critical.

Physical Medicine

Documentation Requirements

Functional assessments should document mobility limitations, pain levels, and the need for assistive devices to facilitate rehabilitation.

Common Clinical Scenarios

Rehabilitation scenarios may include physical therapy to restore range of motion and strength following postimmunization arthropathy.

Billing Considerations

Focus on mobility limitations and the patient's ability to perform daily activities is essential for effective treatment planning.

Coding Guidelines

Inclusion Criteria

Use M02.26 When
  • Official coding guidelines require documentation of laterality (right, left, bilateral) and the severity of symptoms
  • Encounter type (initial, follow
  • up) must also be clearly indicated

Exclusion Criteria

Do NOT use M02.26 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when knee effusion is present and requires aspiration for diagnostic or therapeutic purposes.

Documentation Requirements

Document the indication for the procedure, including the presence of effusion and pain levels.

Specialty Considerations

Orthopedic considerations include assessing joint stability post-procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy, which aids in better tracking and management of these cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy, which aids in better tracking and management of these cases.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    CDC Immunization Guidelines

Coding & Billing References

  • •
    CDC Immunization Guidelines

Frequently Asked Questions

What are the common symptoms of postimmunization arthropathy?

Common symptoms include joint pain, swelling, stiffness, and limited range of motion in the affected knee, typically occurring within days to weeks after vaccination.