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ICD-10 Guide
ICD-10 CodesM22.12

M22.12

Billable

Recurrent subluxation of patella, left knee

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

Code Description

ICD-10 M22.12 is a billable code used to indicate a diagnosis of recurrent subluxation of patella, left knee.

Key Diagnostic Point:

Recurrent subluxation of the patella, particularly in the left knee, is a condition characterized by the intermittent displacement of the patella from its normal position in the femoral groove. This condition often arises due to underlying structural abnormalities, such as malalignment of the lower extremity, ligamentous laxity, or muscular imbalances. Patients typically present with symptoms including knee pain, a sensation of instability, and episodes of the patella slipping out of place, which may be accompanied by swelling and difficulty in weight-bearing activities. The recurrent nature of this condition can lead to chronic pain and functional impairment, necessitating a thorough evaluation to rule out associated internal derangements such as meniscal tears or ligament injuries. Treatment options may include conservative management with physical therapy, bracing, or surgical interventions such as arthroscopy to address any underlying issues and stabilize the patella. Accurate coding is essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between recurrent subluxation and dislocation
  • Identifying associated internal derangements
  • Understanding the implications of previous knee surgeries
  • Documenting the severity and frequency of episodes

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to document associated conditions like meniscal tears
  • Misclassification of the type of knee instability
  • Lack of clarity on treatment plans and outcomes

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, athletes with recurrent knee injuries, and post-operative evaluations.

Billing Considerations

Ensure that all relevant imaging studies are documented, and any surgical interventions are clearly described.

Physical Therapy

Documentation Requirements

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

Common Clinical Scenarios

Rehabilitation following patellar stabilization procedures or conservative management of recurrent subluxation.

Billing Considerations

Document specific therapeutic exercises and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use M22.12 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant history of previous knee injuries or surgeries
  • The code M22
  • 12 is specific to the left knee and should not be used for right knee conditions

Exclusion Criteria

Do NOT use M22.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29880CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when performing a diagnostic arthroscopy to evaluate recurrent subluxation.

Documentation Requirements

Document the reason for the procedure, findings, and any interventions performed.

Specialty Considerations

Orthopedic surgeons should ensure that the surgical report clearly outlines the diagnosis and rationale for the procedure.

27420CPT Code

Arthroplasty, knee, partial, medial or lateral compartment

Clinical Scenario

Used when surgical intervention is required for recurrent subluxation due to severe underlying pathology.

Documentation Requirements

Detail the indications for surgery and pre-operative assessments.

Specialty Considerations

Ensure that all pre-operative imaging and assessments are documented.

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 reimbursement processes.

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 reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 crucial for coding.

When should I use M22.12?

Use M22.12 when documenting recurrent subluxation of the left patella, ensuring that the patient's history and clinical findings support the diagnosis.