Reporting Chondromalacia Patella with ICD-10 Codes

Reporting Chondromalacia Patella with ICD-10 Codes

Chondromalacia patella refers to damage of the cartilage on the underside of the kneecap. The blog lists the causes, treatment and ICD-10 codes for the condition.

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Chondromalacia patella refers to a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens. Regarded as one of the most common causes of knee pain, the degeneration of cartilage occurs due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). Also known as Runner’s knee, the condition is common among young, athletic individuals, but may also occur in older adults who have arthritis of the knee. Dull pain in and around the kneecap (that increases with movement) is one of the most common symptoms of chondromalacia patella. A person with this condition will often complain of a sensation of grinding or cracking whenever the knee is moved.

The pain will often be severe after sitting or standing for a long period of time or during activities that place extreme pressure on the knees, including exercise. If left untreated, the condition can cause swelling and inflammation of the kneecap. Resting, stabilizing, and icing the joint may be the first line of treatment. In addition, anti-inflammatory medications may help reduce inflammation around the joint. Physicians’ practices treating patients with chondromalacia patella pain need to know the ICD-10 codes to report this condition correctly. Outsourced medical billing services from a reputable medical billing and coding company helps in accurate and timely claim filing for appropriate reimbursement.

What Causes Patella Pain?

The patella is the moveable bone on the kneecap which normally resides at the front of the knee joint. Poor alignment of the kneecap (patella) causes chondromalacia patella or patellofemoral syndrome. The condition is the result of repetitive wear and tear of the kneecap, which can occur due to acute injury to the patella or due to aging. In addition, work or sporting activity that puts great stress on the knees increases the risk of developing the condition. Improper knee alignment can occur due to several reasons –

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

A congenital misalignment of the knee



Weak hamstrings and quadriceps (the muscles in the back and front of the thighs, respectively)

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Repeated stress to the knee joint due to running or jumping

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Imbalance of the adductor and abductor muscles on each side of the thigh



Flat feet (pes planus)



A direct blow or trauma to the kneecap

Several factors like age, previous injury to the kneecap, arthritis and high activity levels can increase the risk for developing chondromalacia patella in the long run.

Diagnosing, Grading and Treating Chondromalacia Patella Initial diagnosis of the condition begins with a detailed physical examination wherein the physician will look for areas of swelling or tenderness in the knee. They may also analyze how the kneecap aligns with the thigh bone.

Since kneecap misalignment can be a true indicator of this condition, physicians may also apply resistive pressure to the patient’s extended kneecap to determine the tenderness and severity. Imaging tests such as an X-ray or magnetic resonance imaging (MRI) scan will be done to view bone damage, cartilage wear and tear, signs of misalignment or arthritis. In addition, an arthroscopic exam - a minimally invasive procedure – may also be performed to visualize the inside of the knee. The arthroscopic procedure involves inserting an endoscope and camera into the knee joint.

There are four types of grades – that directly determine the severity of the disease. Grade 1 is the least severe, while grade 4 indicates the greatest severity. 

Grade 1 - indicates softening of the cartilage in the knee area

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

Grade 2 - indicates softening of the cartilage along with abnormal surface characteristics



Grade 3 – indicates thinning of cartilage with active deterioration of the tissue



Grade 4 - the most severe grade - indicates exposure of the bone (bone-to-bone

rubbing)

with

a

significant

portion

of

cartilage

deterioration Treatment for this knee condition aims to reduce the pressure on the kneecap

and

orthopedists,

joint.

A

team

of

pain

management

healthcare

professionals

physicians,

physical

comprising therapists,

chiropractors, and rehab experts may conduct an accurate and detailed analysis of the patient’s condition and decide on a customized treatment plan on that basis.

As an initial line of treatment, physicians may prescribe Rest, Ice application, restriction

of movement, and anti-inflammatory medications such as

ibuprofen to reduce inflammation around the joint. However, if swelling, tenderness, and pain persist, physical therapy exercise programs will be recommended to help improve muscle strength and balance. Muscle balance will help prevent knee misalignment in the long run.

If any of the above non-surgical treatment methods fail to provide the desired results, surgery will be considered as a last option. Surgical options include arthroscopic procedure (to check whether there is misalignment of the knee), smoothing the back of the kneecap, implanting a cartilage graft, or relocating the insertion of the thigh muscle. Treatment procedures and other tests performed by physicians must be carefully documented using the correct medical codes. Medical billing and coding outsourcing services provided by reliable medical billing companies can help physicians use the correct codes for their billing purposes. www.outsourcestrategies.com

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ICD-10 codes for diagnosing Chondromalacia Patellae include – M22.2 - Patellofemoral disorders 

M22.2X - Patellofemoral disorders  M22.2X1 - Patellofemoral disorders, right knee  M22.2X2 - Patellofemoral disorders, left knee  M22.2X9 - Patellofemoral disorders, unspecified knee

M22.3 - Other derangements of patella 

M22.3X - Other derangements of patella  M22.3X1 - Other derangements of patella, right knee  M22.3X2 - Other derangements of patella, left knee  M22.3X9 - Other derangements of patella, unspecified knee

M22.4 - Chondromalacia patellae 

M22.40 - Chondromalacia patellae, unspecified knee



M22.41 - Chondromalacia patellae, right knee



M22.42 - Chondromalacia patellae, left knee

Avoiding activities that give repeated stress to the knee cap may help prevent the occurrence of chondromalacia patellae knee condition. Excess body weight exerts great pressure on the knees. Therefore, maintaining a healthy body weight can help reduce the extra stress on the knees and other joints. Wearing kneepads will be appropriate for people who have to spend more time standing. Wear shoe inserts that correct flat feet by increasing your arch. This will also reduce the total amount of pressure placed on the knees and may realign the kneecap.

Documenting Chondromalacia Patella for medical claims requires adequate knowledge

regarding

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updates

in

medical

billing

and

coding

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policies. Orthopedic medical billing services provided by an experienced medical billing and coding company can help physicians with timely claims processing and collections, and proper revenue management.

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