Wiki Verbiage vs. Code Clarafication

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smh1312

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I need clarifcation if the way my provider is documenting arthritis for the knee is acceptable or not. The chart note will state Arthritis of the Right knee, along with the Dx M17.11, which is Primary Osteoarthritis of the right knee. It's my understanding that the type of arthritis should be stated to support M17.11 in the note. Am I incorrect or over thinking this?
 
gbgentry@earthlink.net said:
Just overthinking (happens to everyone!)
If you look, Arthritis, unspecified takes you to OA when you walk thru.
Click to expand...

Not to M17.11 though.

Arthritis, unspecified takes you to M19.90 in the index.

M17.11 is primary osteoarthritis of the right knee. The physician would need to document that it is primary osteoarthritis to use the M17.11 code.


Osteoarthritis, unspecified site

Physician Tip: Assign M19.90 when neither the site nor the type of osteoarthritis - primary, secondary, or post-traumatic - is documented.

Unspecified osteoarthritis, unspecified site
Arthritis NOS
Arthrosis NOS
Osteoarthritis NOS
 
They give you "Arthritis of the Right knee" from the chart so you don't have to go to Unspecified like the above poster did.

Arthritis - Unspecified - Knee - Other/unspecified - Unilateral - Right
M17.11
 
I agree with @gbgentry@earthlink.net if it says Right Knee that is the location/site. The anatomical location is identified. M19.90 is if they only said arthritis and not where it was located which would be really weird.
M19.90 is if the site is unspecified.
It would always be best if the provider actually states osteoarthritis or primary OA or something like that.
 
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