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ICD-10 Guide
ICD-10 CodesM22.11

M22.11

Billable

Recurrent subluxation of patella, right knee

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

Code Description

ICD-10 M22.11 is a billable code used to indicate a diagnosis of recurrent subluxation of patella, right knee.

Key Diagnostic Point:

Recurrent subluxation of the patella in the right knee is a condition characterized by the intermittent displacement of the patella (kneecap) from its normal position in the femoral groove. This condition often results from a combination of anatomical factors, such as a shallow femoral groove, ligamentous laxity, and muscle imbalances. Patients may experience episodes of the patella slipping out of place, which can lead to pain, swelling, and instability in the knee. The recurrent nature of this condition can significantly impact a patient's mobility and quality of life. Diagnosis typically involves a thorough clinical examination, imaging studies such as X-rays or MRI, and an assessment of the patient's history of knee injuries. Treatment options may include physical therapy, bracing, and in some cases, surgical intervention to stabilize the patella. Understanding the underlying causes and the mechanics of the knee joint is crucial for effective management and rehabilitation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between recurrent subluxation and dislocation
  • Need for detailed documentation of patient history and physical examination findings
  • Potential for co-existing conditions such as meniscal tears or ligament injuries
  • Variability in treatment approaches and their documentation

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to document associated injuries or conditions
  • Lack of clarity in treatment plans and outcomes
  • Misclassification of the condition as a simple subluxation or dislocation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with knee pain and instability, history of patellar dislocation, or previous knee surgeries.

Billing Considerations

Documentation must clearly differentiate between subluxation and dislocation, and include any associated ligament or meniscal injuries.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation exercises, patient response, and functional outcomes.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those with chronic instability requiring conservative management.

Billing Considerations

Therapists should document specific exercises aimed at strengthening the quadriceps and stabilizing the patella.

Coding Guidelines

Inclusion Criteria

Use M22.11 When
  • According to ICD
  • 10 guidelines, M22
  • 11 should be used when the documentation specifies recurrent subluxation of the right patella
  • It is important to ensure that the condition is not confused with other knee injuries or conditions

Exclusion Criteria

Do NOT use M22.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, surgical; with reconstruction of the anterior cruciate ligament

Clinical Scenario

Used in cases where surgical intervention is required for recurrent subluxation.

Documentation Requirements

Operative report detailing the procedure, indications, and findings.

Specialty Considerations

Orthopedic surgeons must document the specific techniques used and any associated procedures performed.

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 dislocation where the joint surfaces are still in contact, while dislocation is a complete separation of the joint surfaces. Accurate coding depends on this distinction.