Musculoskeletal condition M94.262 — ICD-10 M94.262

ICD-10: M94.262 | Category: Musculoskeletal Disorders | Billable: Yes

ICD-10 code M94.262 refers to a specific musculoskeletal condition characterized by other specified disorders of the cartilage in the lower limb, particularly affecting the knee region. This classification encompasses various pathologies that can lead to pain, dysfunction, and compromised mobility due to cartilage degeneration or abnormalities. Understanding this condition is essential for clinicians, rehabilitation providers, and patients alike, as it informs treatment protocols and recovery expectations.

The knee joint is a complex structure composed of bones, cartilage, ligaments, tendons, and synovial fluid. The primary bones involved are the femur (thigh bone), tibia (shin bone), and patella (kneecap). Cartilage plays a crucial role in cushioning these bones during movement and weight-bearing activities.

Key Anatomical Structures:

• Articular Cartilage: This smooth tissue covers the ends of bones in the knee joint, allowing for frictionless movement.
• Menisci: These crescent-shaped cartilages act as shock absorbers between the femur and tibia.
• Ligaments: The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) stabilize the knee during motion.

Biomechanics:

During activities such as walking, running, or jumping, the knee experiences significant forces. Proper biomechanics involve coordinated movements of flexion and extension while maintaining stability. When cartilage is compromised, these movements can lead to increased stress on surrounding tissues, resulting in pain and functional limitations.

Patient presents with chronic pain in the right shoulder, diagnosed with a musculoskeletal disorder related to repetitive strain from work. Code as M94.262 because the documentation reflects a specific diagnosis related to a musculoskeletal condition that impacts the patient's functional capacity, supported by clinical evaluation and history.

To support medical necessity for coding M94.262 and to prevent claim denials, the following documentation elements are critical:

1. Detailed Patient History: Comprehensive documentation of the patient's symptoms, including onset, duration, and any precipitating factors.

1. Clinical Findings: Clear description of physical examination results and any imaging studies that support the diagnosis.

1. Treatment Plan: An outlined plan that includes specific interventions, such as referrals to physical therapy or occupational therapy, and follow-up care instructions.

1. Progress Notes: Regular updates on the patient’s response to treatment and any modifications made to the care plan.

Subjective: A 45-year-old female office worker reports persistent pain in her right shoulder, which has worsened over the past three months. She describes the pain as a dull ache that increases with overhead activities and typing. Objective: Physical examination reveals tenderness in the right shoulder, limited range of motion, and no swelling. An MRI shows mild inflammation in the rotator cuff area. Assessment: Right shoulder musculoskeletal condition (M94.262) likely due to repetitive strain from prolonged computer use. Plan: Initiate a physical therapy program focusing on shoulder stabilization exercises, recommend ergonomic adjustments at her workstation, and schedule a follow-up appointment in four weeks to reassess her condition.

Several conditions may mimic symptoms associated with M94.262:

1. Osteoarthritis (M17): Degenerative joint disease affecting articular cartilage.
2. Rheumatoid Arthritis (M05): An autoimmune disorder causing joint inflammation.
3. Meniscal Tear (S83.2): Injury to the menisci leading to similar symptoms.
4. Patellar Tendinopathy (M76.6): Inflammation of the patellar tendon causing anterior knee pain.

When documenting M94.262 in electronic medical records (EMR), ensure clarity in your notes regarding:

1. Patient history detailing symptom onset and progression.
2. Physical examination findings including range of motion assessments.
3. Diagnostic imaging results supporting your diagnosis.
4. Treatment plans outlining rehabilitation protocols.

For billing purposes, ensure accurate coding that reflects all services provided during each visit, including evaluations, treatments, and follow-up care.