Facebook tracking pixel
M25.462
ICD-10-CM
Swelling of the Left Knee

Find information on left knee swelling diagnosis, including differential diagnoses, clinical findings, ICD-10 codes (M25.461, M25.462, others), medical coding, documentation best practices, and healthcare resources for knee effusion, left knee pain, hemarthrosis, internal derangement of the left knee, and osteoarthritis of the left knee. Learn about symptoms, causes, and treatment options for left knee swelling from trusted medical sources.

Also known as

Left Knee Effusion
Left Knee Swelling

Diagnosis Snapshot

Key Facts
  • Definition : Excess fluid buildup in the left knee joint causing noticeable enlargement.
  • Clinical Signs : Pain, stiffness, limited range of motion, warmth, redness, tenderness to the touch.
  • Common Settings : Sports injuries, arthritis, overuse, infection, trauma, gout, bursitis.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M25.462 Coding
M25.46

Pain in left knee

Swelling is often associated with knee pain.

M17.12

Unilateral primary OA, left knee

Osteoarthritis can cause swelling in the knee.

M23.92

Internal derangement, left knee

Includes meniscus tears, which cause swelling.

S83.602A

Sprain of left knee, initial

Knee sprains frequently involve swelling.

Code-Specific Guidance

Decision Tree for

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

Is the swelling due to trauma/injury?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Swelling, left knee
Left knee effusion
Left knee osteoarthritis

Documentation Best Practices

Documentation Checklist
  • Left knee swelling: onset, duration, character
  • Location and extent of swelling: localized or diffuse
  • Pain assessment: location, type, severity, aggravating/relieving factors
  • ROM limitations: flexion, extension, impact on mobility
  • Associated symptoms: redness, warmth, tenderness, instability

Coding and Audit Risks

Common Risks
  • Laterality Specificity

    Missing documentation clarifying if swelling is specific to the left knee or involves other areas, impacting code selection (e.g., M25.461 vs. M25.469).

  • Underlying Cause

    Failure to document the etiology of the swelling (e.g., trauma, infection) leads to inaccurate coding and potential underreporting of severity for reimbursement.

  • Effusion vs. Swelling

    Lack of clear distinction between knee effusion (fluid accumulation) and general swelling can lead to incorrect code assignment (e.g., M25.46 vs. other joint disorders).

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (e.g., M25.461) for left knee swelling.
  • Thorough HPI documentation: onset, location, characteristics of swelling.
  • Specific physical exam details: ROM, tenderness, effusion, skin changes.
  • Consider diagnostic imaging: X-ray, MRI, ultrasound to rule out other causes.
  • Document interventions and patient education for compliance and improved outcomes.

Clinical Decision Support

Checklist
  • Verify left knee trauma Hx (ICD-10 S83.-)
  • Assess effusion, tenderness, ROM (SNOMED CT 271728001)
  • R/O DVT via Wells criteria, imaging (ICD-10 I82.403)
  • Consider inflammatory arthritis, labs/imaging (ICD-10 M00-M25)

Reimbursement and Quality Metrics

Impact Summary
  • Swelling Left Knee: ICD-10 719.06, CPT 99201-99215 (Eval & Mgmt), optimize coding for accurate reimbursement.
  • Impact: Proper coding maximizes revenue, avoids denials for knee swelling diagnosis claims.
  • Impact: Accurate knee swelling documentation improves quality reporting metrics, patient outcomes.
  • Impact: Optimized medical billing workflow reduces claim processing time, enhances hospital revenue cycle.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Code laterality: left knee
  • Document swelling specifics
  • Rule out trauma, infection
  • Consider 719.46, M25.46
  • Check for effusion documentation

Documentation Templates

Patient presents with complaints of left knee swelling.  Onset of swelling is reported as (onset duration - e.g., acute, gradual, 2 days, 3 weeks).  Patient describes the pain as (pain quality - e.g., sharp, dull, aching, throbbing) and rates the pain as (pain scale rating) on a 0-10 scale.  The location of the swelling is noted as (specific location - e.g., generalized, localized to medial aspect, localized to lateral aspect).  Associated symptoms include (list associated symptoms - e.g., stiffness, limited range of motion, erythema, warmth, locking, popping, instability, bruising, tenderness to palpation).  Mechanism of injury, if any, is described as (description of injury - e.g., twisting injury while playing basketball, fall onto the knee, insidious onset).  Patient's medical history includes (list relevant medical history - e.g., osteoarthritis, rheumatoid arthritis, previous knee injury, surgery).  Physical examination reveals (objective findings - e.g., palpable effusion, increased warmth, erythema, tenderness to palpation along the joint line, limited range of motion, crepitus, positive McMurray's test).  Differential diagnosis includes (list potential diagnoses - e.g., knee effusion, osteoarthritis, meniscus tear, ligament sprain, bursitis, septic arthritis, gout, pseudogout).  Initial treatment plan includes (treatment plan - e.g., RICE protocol rest, ice, compression, elevation, NSAIDs, referral to orthopedics, arthrocentesis, imaging studies such as X-ray or MRI).  Patient education provided regarding (patient education topics - e.g., activity modification, ice application, medication management, follow-up care).  Follow-up scheduled in (duration - e.g., 1 week, 2 weeks) to reassess symptoms and discuss further management.
Swelling of the Left Knee - AI-Powered ICD-10 Documentation