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v1.0.0
ICD-10 Guide
ICD-10 CodesM02.262

M02.262

Billable

Postimmunization arthropathy, left knee

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

Code Description

ICD-10 M02.262 is a billable code used to indicate a diagnosis of postimmunization arthropathy, left knee.

Key Diagnostic Point:

Postimmunization arthropathy refers to joint pain and inflammation that occurs following vaccination. In the case of the left knee, this condition may manifest as swelling, stiffness, and pain localized to the knee joint. Anatomically, the knee consists of the femur, tibia, fibula, patella, and surrounding ligaments and cartilage. The pathophysiology involves an immune response triggered by the vaccine, which may lead to synovitis or inflammation of the synovial membrane. Clinically, patients may present with limited range of motion, tenderness, and warmth over the joint. Symptoms typically arise within days to weeks post-vaccination and can vary in duration. It is essential to differentiate this condition from other forms of arthritis, such as rheumatoid arthritis or post-traumatic arthritis, to ensure appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunological responses to vaccines
  • Differentiation from other arthropathies
  • Documentation of laterality and specific joint involvement
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Inadequate documentation of vaccination history
  • Failure to specify laterality
  • Misclassification of the type of arthropathy
  • Lack of supporting clinical evidence for the diagnosis

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.

Common Clinical Scenarios

Patients may present with knee pain post-vaccination, requiring evaluation for potential surgical intervention if conservative management fails.

Billing Considerations

Joint-specific considerations include assessing for any structural damage or chronic changes that may complicate the postimmunization arthropathy.

Rheumatology

Documentation Requirements

Rheumatologic documentation should include laboratory tests for inflammation markers (e.g., ESR, CRP) and assessments of disease activity.

Common Clinical Scenarios

Patients may have a history of autoimmune conditions that could complicate the presentation of postimmunization arthropathy.

Billing Considerations

Systemic involvement should be monitored, especially in patients with pre-existing rheumatologic disorders.

Physical Medicine

Documentation Requirements

Functional assessments should evaluate mobility limitations and rehabilitation needs, including physical therapy referrals.

Common Clinical Scenarios

Patients may require rehabilitation to restore function and alleviate pain post-vaccination.

Billing Considerations

Assistive device needs should be documented to support functional independence.

Coding Guidelines

Inclusion Criteria

Use M02.262 When
  • Official coding guidelines require documentation of laterality (left knee), severity of symptoms, and the type of encounter (initial visit, follow
  • Accurate coding also necessitates a clear link between the immunization and the arthropathy

Exclusion Criteria

Do NOT use M02.262 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to assess postimmunization arthropathy symptoms.

Documentation Requirements

Documentation must include history, examination findings, and treatment plan.

Specialty Considerations

Orthopedic and rheumatologic considerations for ongoing management.

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

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.

Resources

Clinical References

  • •
    CDC Immunization Guidelines
  • •
    American Academy of Orthopaedic Surgeons (AAOS) Guidelines

Coding & Billing References

  • •
    CDC Immunization Guidelines
  • •
    American Academy of Orthopaedic Surgeons (AAOS) Guidelines

Frequently Asked Questions

What is postimmunization arthropathy?

Postimmunization arthropathy is a condition characterized by joint pain and inflammation that occurs following vaccination. It is typically self-limiting and requires careful documentation to differentiate it from other arthritic conditions.