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M25.561
ICD-10-CM
Right Knee Pain

Find information on right knee pain diagnosis, including relevant medical codes (ICD-10, SNOMED CT), clinical documentation best practices, differential diagnosis considerations, and common symptoms like lateral knee pain, medial knee pain, anterior knee pain, and posterior knee pain. Learn about relevant healthcare specialties like orthopedics, sports medicine, and physical therapy for effective right knee pain management and treatment. Explore resources for accurate clinical evaluation and documentation of right knee pain.

Also known as

Pain in right knee
Right knee discomfort
R Knee Pain
+1 more

Diagnosis Snapshot

Key Facts
  • Definition : Discomfort or pain localized to the right knee joint.
  • Clinical Signs : Swelling, stiffness, limited range of motion, tenderness to touch, clicking or popping.
  • 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

Degenerative joint disease of the knee, a common cause of knee pain.

S83.501A

Sprain of right knee

Ligament injury in the right knee causing pain and instability.

M79.661

Pain in right lower leg

Pain radiating to the right lower leg, sometimes originating from 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

    Is a fracture confirmed?

  • No

    Is there a specific diagnosis?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Right Knee Pain
Right Knee Osteoarthritis
Right Knee Meniscus Tear

Documentation Best Practices

Documentation Checklist
  • Right knee pain: Onset, duration, character
  • Location and laterality: Medial, lateral, patellar
  • Aggravating and alleviating factors documented
  • Associated symptoms: Swelling, stiffness, instability
  • Physical exam: ROM, tenderness, effusion

Coding and Audit Risks

Common Risks
  • Unspecified Pain Code

    Using unspecified codes like M25.561 (right knee pain) without proper documentation of cause, impacting reimbursement and data accuracy. Medical coding, CDI, healthcare compliance.

  • Laterality Coding Errors

    Incorrectly coding laterality (right vs. left) leading to inaccurate claims and potential compliance issues. Medical coding, knee pain, CDI.

  • Underlying Cause Missed

    Coding only pain (M25.561) without coding the underlying diagnosis (e.g., osteoarthritis), affecting quality reporting and reimbursement. Healthcare compliance, CDI, medical coding.

Mitigation Tips

Best Practices
  • Document laterality: specify right knee pain.
  • Code precise pain location: anterior, posterior, medial, lateral.
  • Include symptom details: onset, duration, character, exacerbating factors.
  • Query physician for pain etiology: trauma, overuse, arthritis, etc.
  • Use ICD-10 codes for accurate diagnosis: M25.561, M25.562, etc.

Clinical Decision Support

Checklist
  • Verify laterality: Right knee documented
  • Assess pain characteristics: Onset, type, location
  • Physical exam: ROM, swelling, tenderness
  • Review imaging: X-ray, MRI if indicated
  • Consider DDx: OA, meniscus tear, ligament injury

Reimbursement and Quality Metrics

Impact Summary
  • Right Knee Pain: Coding accuracy impacts reimbursement for M79.60 (Unspecified), M79.65 (Lateral Femoral Condyle), M79.66 (Medial Tibial Condyle), etc. Proper documentation is crucial.
  • Accurate knee pain diagnosis coding affects quality metrics like pain management effectiveness and patient satisfaction scores reported to CMS.
  • Knee pain diagnosis coding errors lead to claim denials, reduced revenue, and skewed hospital quality data impacting public rankings and value-based payments.
  • Specificity in right knee pain coding (e.g., laterality, traumatic vs. overuse) improves data accuracy for research and resource allocation.

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 location
  • Document injury details
  • Consider underlying cause
  • Check 719.46 validity

Documentation Templates

Patient presents with right knee pain.  Onset of pain is described as (acute, subacute, chronic) and began (duration) ago.  The patient localizes the pain to the (medial, lateral, anterior, posterior) aspect of the knee and characterizes it as (sharp, dull, aching, throbbing, burning).  Aggravating factors include (weight-bearing, stairs, prolonged standing, bending, twisting) and alleviating factors include (rest, ice, elevation, over-the-counter pain relievers such as ibuprofen or acetaminophen).  Patient denies any history of trauma, injury, or fall to the right knee.  Past medical history includes (relevant medical conditions such as osteoarthritis, rheumatoid arthritis, gout).  Surgical history includes (any prior knee surgeries).  Medications include (list current medications).  Allergies include (list allergies).  Physical examination reveals (tenderness to palpation, swelling, erythema, warmth, crepitus, limited range of motion, effusion, instability).  McMurray's test is (positive, negative).  Lachman's test is (positive, negative).  Anterior drawer test is (positive, negative).  Posterior drawer test is (positive, negative).  Varus and valgus stress tests are (stable, unstable).  Neurovascular examination of the right lower extremity is intact.  Assessment: Right knee pain, likely due to (differential diagnosis such as osteoarthritis, meniscus tear, ligament sprain, tendinitis, bursitis).  Plan:  Conservative management includes (rest, ice, compression, elevation, physical therapy, over-the-counter pain relievers such as NSAIDs).  Imaging studies such as (X-ray, MRI) may be ordered to further evaluate the cause of the pain.  Referral to orthopedics may be indicated if symptoms persist or worsen.  Patient education provided regarding activity modification, pain management, and follow-up care.  Return to clinic in (duration) for reevaluation.
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