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ICD-10 Guide
ICD-10 CodesM22.9

M22.9

Billable

Unspecified disorder of patella

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

Code Description

ICD-10 M22.9 is a billable code used to indicate a diagnosis of unspecified disorder of patella.

Key Diagnostic Point:

The unspecified disorder of the patella (M22.9) encompasses a range of conditions affecting the kneecap, which may include internal derangements, meniscal tears, ligament injuries, and other pathologies. The patella plays a crucial role in knee mechanics, and disorders can lead to pain, instability, and functional impairment. Internal derangements may involve the displacement of the patella, leading to patellar subluxation or dislocation. Meniscal tears, while primarily involving the menisci, can also affect the patellar tracking and contribute to pain and dysfunction. Ligament injuries, particularly to the anterior cruciate ligament (ACL) or medial collateral ligament (MCL), can also impact patellar stability. Arthroscopic procedures are often employed to diagnose and treat these conditions, allowing for direct visualization and intervention within the knee joint. Accurate coding for M22.9 requires careful consideration of the clinical presentation and documentation, as the unspecified nature of the code necessitates a thorough understanding of the underlying pathology and its implications for treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation to support unspecified diagnosis
  • Differentiation from other knee disorders
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Insufficient documentation to support the unspecified diagnosis
  • Inconsistent use of the code across different providers
  • Failure to document co-existing knee conditions
  • Lack of clarity in clinical notes regarding the nature of the disorder

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with knee pain, instability, or history of trauma.

Billing Considerations

Ensure that all relevant findings are documented to support the unspecified diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and treatment goals.

Common Clinical Scenarios

Rehabilitation following knee surgery or injury.

Billing Considerations

Document the impact of the patellar disorder on functional abilities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use M22.9 When
  • According to ICD
  • 10 guidelines, M22
  • 9 should be used when the specific nature of the patellar disorder is not documented
  • Coders should ensure that all relevant clinical information is captured to justify the use of this unspecified code

Exclusion Criteria

Do NOT use M22.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29881CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when performing arthroscopy to evaluate patellar disorders.

Documentation Requirements

Document indication for arthroscopy and findings.

Specialty Considerations

Orthopedic surgeons should ensure clear documentation of the rationale for the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding, but M22.9 remains a common code due to its unspecified nature. Coders must be diligent in documenting the clinical rationale for its use to avoid audit issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding, but M22.9 remains a common code due to its unspecified nature. Coders must be diligent in documenting the clinical rationale for its use to avoid audit issues.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding, but M22.9 remains a common code due to its unspecified nature. Coders must be diligent in documenting the clinical rationale for its use to avoid audit issues.

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

When should I use M22.9?

M22.9 should be used when the specific nature of the patellar disorder is not documented, and it is essential to ensure that all relevant clinical information is captured to justify the unspecified diagnosis.