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ICD-10 Guide
ICD-10 CodesM22.1

M22.1

Billable

Recurrent subluxation of patella

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M22.1 is a billable code used to indicate a diagnosis of recurrent subluxation of patella.

Key Diagnostic Point:

Recurrent subluxation of the patella is a condition characterized by the intermittent displacement of the patella (kneecap) from its normal position in the femoral groove. This condition often arises due to underlying anatomical abnormalities, such as a shallow femoral groove, ligamentous laxity, or muscle imbalances. Patients typically present with episodes of knee instability, pain, and swelling, particularly during activities that involve bending or twisting the knee. The recurrent nature of the subluxation can lead to chronic pain and functional limitations, necessitating a thorough evaluation and management plan. Internal derangements, such as meniscal tears or ligament injuries, may accompany recurrent patellar subluxation, complicating the clinical picture. Arthroscopic procedures are often employed to address these issues, allowing for direct visualization and treatment of the patellar tracking abnormalities, as well as any associated meniscal or ligamentous injuries. Proper diagnosis and management are crucial to prevent long-term complications, including osteoarthritis and persistent knee instability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between subluxation and dislocation
  • Identifying associated internal derangements
  • Documenting recurrent episodes accurately
  • Understanding the relationship with other knee injuries

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to document associated injuries or conditions
  • Misclassification of subluxation as dislocation
  • Lack of detailed treatment plans

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of knee instability, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with knee pain and instability, particularly athletes or active individuals.

Billing Considerations

Ensure documentation reflects the recurrent nature of the condition and any associated injuries.

Physical Therapy

Documentation Requirements

Assessment of functional limitations, treatment goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those receiving conservative management for patellar instability.

Billing Considerations

Document specific therapeutic interventions and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use M22.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the recurrent nature of the condition
  • Include any associated injuries or conditions that may affect treatment and outcomes

Exclusion Criteria

Do NOT use M22.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29880CPT Code

Arthroscopy, knee, surgical; with meniscectomy

Clinical Scenario

Used when a meniscal tear is present alongside recurrent subluxation.

Documentation Requirements

Document the presence of meniscal injury and the surgical approach taken.

Specialty Considerations

Orthopedic surgeons should ensure detailed operative notes are provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like recurrent subluxation of the patella, improving the accuracy of patient records and facilitating better treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like recurrent subluxation of the patella, improving the accuracy of patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like recurrent subluxation of the patella, improving the accuracy of patient records and facilitating better treatment planning.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between subluxation and dislocation?

Subluxation refers to a partial displacement of the patella, while dislocation is a complete displacement. Accurate documentation is essential to differentiate between the two for proper coding.