Facebook tracking pixel
M25.561
ICD-10-CM
Pain Right Knee

Find information on right knee pain diagnosis, including relevant medical codes, clinical documentation tips, and differential diagnoses. Explore resources for healthcare professionals covering right knee pain assessment, symptoms, treatment, and ICD-10 codes like M25.561 and M25.562. Learn about common causes such as osteoarthritis, meniscus tears, ligament injuries, and patellofemoral pain syndrome. Improve your medical coding accuracy and clinical documentation for right knee pain.

Also known as

Right Knee Pain
Knee Pain Right Side

Diagnosis Snapshot

Key Facts
  • Definition : Discomfort or tenderness in the right knee joint.
  • Clinical Signs : Swelling, stiffness, limited range of motion, warmth, redness, clicking or popping sounds.
  • Common Settings : Arthritis, injury (meniscus tear, ligament sprain), overuse, bursitis.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M25.561 Coding
M25.561

Pain in right knee

Pain localized to the right knee joint.

M17

Gonarthrosis

Osteoarthritis of the knee, a common cause of knee pain.

S83

Dislocation and sprain of knee

Injuries to the knee that can cause pain.

M79.601

Pain in right lower leg

Pain radiating to the lower leg, which may originate in the knee.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the right knee pain traumatic?

  • Yes

    Current injury?

  • No

    Is there a documented underlying medical condition?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Pain Right Knee
Right Knee Osteoarthritis
Right Knee Meniscus Tear

Documentation Best Practices

Documentation Checklist
  • Pain Right Knee: Onset, duration, character
  • Location and laterality: Specify right knee
  • Aggravating and alleviating factors
  • Associated symptoms: Swelling, clicking, etc.
  • Impact on ADLs: Walking, stairs, etc.

Coding and Audit Risks

Common Risks
  • Laterality Unspecified

    Coding right knee pain without specifying laterality (right) can lead to claim rejections and inaccurate data reporting. Use appropriate laterality codes.

  • Specificity Lacking

    Generalized pain coding lacks detail needed for proper reimbursement. Document underlying cause, type of pain, and associated symptoms for specific code assignment.

  • Medical Necessity

    Insufficient documentation supporting medical necessity of services related to right knee pain can trigger audits and denials. Clearly link diagnoses and treatments.

Mitigation Tips

Best Practices
  • Document laterality: specify right knee pain.
  • Code specifics: avoid unspecified knee pain codes (e.g., M25.561).
  • Query for clarity: If pain cause is unclear, query physician.
  • Detail pain characteristics: sharp, dull, aching, radiating.
  • Include onset, duration, and exacerbating/relieving factors.

Clinical Decision Support

Checklist
  • Verify laterality: Is pain definitively in RIGHT knee?
  • Document pain onset, character, radiation, and timing.
  • Assess for swelling, redness, warmth, and ROM limitations.
  • Consider imaging (X-ray, MRI) based on exam findings.
  • Evaluate for prior knee injuries or relevant medical history.

Reimbursement and Quality Metrics

Impact Summary
  • Pain Right Knee: Accurate coding (M79.651, M25.561, others) impacts reimbursement.
  • Coding validity affects quality metrics for knee pain (e.g., WOMAC).
  • Hospital reporting accuracy for right knee pain tied to diagnosis codes.
  • Denial reduction via specific laterality coding (right vs. left) for knee pain.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code knee pain laterality
  • Specify pain type, acuity
  • Document exam findings
  • Consider imaging, procedures
  • Check M79.65, other codes

Documentation Templates

Patient presents with complaints of right knee pain.  Onset of pain is reported as (onset date or duration, e.g., two weeks ago, gradual over several months).  The pain is characterized as (quality of pain, e.g., sharp, dull, aching, throbbing) and located in the (specific location, e.g., medial, lateral, anterior, posterior) aspect of the right knee.  Patient reports the pain is (severity on a scale of 0-10, e.g., 5/10) and is aggravated by (aggravating factors, e.g., weight-bearing, walking, stairs, prolonged standing).  Alleviating factors include (alleviating factors, e.g., rest, ice, elevation).  Associated symptoms include (associated symptoms, e.g., stiffness, swelling, clicking, locking, giving way).  Patient denies (denied symptoms, e.g., fever, chills, numbness, tingling).  Physical examination reveals (objective findings, e.g., tenderness to palpation over the medial joint line, mild effusion, full range of motion with pain at end range of flexion).  Differential diagnosis includes osteoarthritis, meniscus tear, ligament sprain, patellofemoral pain syndrome, bursitis.  Assessment: Right knee pain.  Plan:  Conservative management with (treatment plan, e.g., NSAIDs, ice, rest, physical therapy referral).  Patient education provided on activity modification and home exercises.  Follow-up scheduled in (duration, e.g., two weeks) to assess response to treatment.  ICD-10 code:  (appropriate ICD-10 code, e.g., M25.561 Pain in right knee).
Pain Right Knee - AI-Powered ICD-10 Documentation