Patellofemoral syndrome or runner’s knee is common, painful injury treated in the outpatient setting. PFS presents with pain in the front of the knee and around the patella, or kneecap. According to the American Academy of Family Physicians, PFS is the most common cause of knee pain in the population. The condition affects adolescents, young people, manual workers, and older adults, and is often seen in athletes. Orthopedists, physical medicine and rehabilitation (PM&R) physicians and sports medicine specialists are uniquely qualified to evaluate, diagnose and manage knee pain. There are various knee diagnosis and procedure codes and physicians can rely on orthopaedic medical billing and coding services to report the right codes and get paid for their services. Causes and Symptoms Patellofemoral syndrome is the most common running injury seen by sports medicine specialists. Pain due to overloading, overuse and misuse of the patellofemoral joint usually results from vigorous athletics or training, previous dislocation or other knee trauma, and alignment issues with the kneecap, weak thigh muscles, tight Achilles tendons and hamstrings, and poor foot support can also cause the condition. The patellofemoral compartment has also been found to be at the highest risk of developing osteoarthritis after ACL injuries. This condition is called patellofemoral osteoarthritis. Common symptoms include pain in and around the kneecap, pain, weakness or feelings of instability after sitting for a long time with the knees bent. The area of the kneecap can also become tender to the touch. Popping, crunching and clicking sounds when the knee is moved is another common symptom. Patellofemoral pain and stiffness usually make it difficult to climb stairs, do activities that require bending the knees, and other everyday activities that stress the joint. Diagnosis The area of the kneecap will be examined to check for tenderness, and evaluate the stability, alignment and strength of the knee and thigh muscles. The physical exam will also include a biomechanical assessment to check for muscle weakness at the hip. Blood tests and diagnostic imaging tests such as an x-ray or MRI may be ordered for exclusion of all other conditions that may cause anterior knee pain. ICD-10 Codes The ICD-10 code for Patellofemoral disorders is M22.2. Patellofemoral disorders, unspecified knee M22. 2X9 is a billable/specific ICD-10 code that can be used to indicate a diagnosis for reimbursement purposes.
Treatment Treatment depends on individual patient considerations such as age, overall health and history, extent of pain, potential for compliance with specific medicines, procedures, or therapies, expected duration of the condition, and opinions or preference. Treatments for patellofemoral syndrome include:
CPT Codes for Arthroscopy and Arthroplasty Knee Procedures Knee Arthroscopy CPT codes 29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external
fixation (includes arthroscopy) Knee Arthroplasty CPT Codes 27438 Arthroplasty, patella; with prosthesis Coding Guidance The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
A 2020 AAPC article provides further guidance:
Although patellofemoral syndrome (PFS) is a common condition and knee arthroscopy is widely performed, reporting diagnosis and treatment can be complicated. Accurate coding is essential for proper payment for procedures performed. Distinguishing between diagnostic and therapeutic procedures, understanding the code definitions, and knowing Medicare and CPT guidelines is essential for correct billing. Complete and accurate documentation that supports diagnosis and the medical necessity of the problems addressed is also paramount. With accurate documentation, medical billing companies can ensure proper claims submission and ensure that providers get paid for services delivered. What is ICDICD-10 code M17. 11 for Unilateral primary osteoarthritis, right knee is a medical classification as listed by WHO under the range - Arthropathies .
What is the ICDICD-10 code M17. 9 for Osteoarthritis of knee, unspecified is a medical classification as listed by WHO under the range - Arthropathies .
What is the ICDICD-10-CM Code for Unilateral primary osteoarthritis, left knee M17. 12.
What code is M19 90?ICD-10 code M19. 90 for Unspecified osteoarthritis, unspecified site is a medical classification as listed by WHO under the range - Arthropathies .
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