How to Document and Code Patellar Tendinitis Using ICD-10

Hi, everybody and welcome to our podcast series. My name is Meghann Kiernan and I’m a Senior Solutions Manager with Outsource Strategies International (OSI). Today I’ll be discussing how to document and code patellar tendonitis using ICD-10.

First, let me get a little into the background of patellar tendinitis and what exactly it is. Those of you familiar with sports have probably heard of this many times before, but for those of you who haven’t, here is the run down.

Patellar tendonitis is a common injury or inflammation of the tendon that connects your knee cap to your shin bone (or your patella to your tibia). The patella tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump. Your pain can be mild or severe when this is injured.

Typical signs pointing to a diagnosis of the patellar tendon rupture include inability to place weight on the involved leg, inability to extend the knee, significant bruising, and pain or tenderness around the area. For complete ruptures of the patellar tendon, surgery is recommended, which is followed by certain rehab programs and exercises.

Anybody can get patellar tendonitis, but it is such a frequent injury of athletes, especially those who play volley ball and basketball, that it’s called jumper’s knee. Among recreational volleyball players, an estimated 14.4 percent have jumper’s knee. The prevalence is even higher for top professional athletes. An estimated 40 to 50 percent of elite volleyball players have jumper’s knee. It’s also really common area amongst NBA players. For example, the recent case was that of Andre Roberson, an American professional basketball player for the Oklahoma City Thunder. His left knee remained mostly immobile, as the result of the torn patellar tendon he suffered on January 27, 2018. This injury actually ended his season. This Oklahoma City Thunder lockdown defender had missed eight games earlier this season with tendinitis in that same left patellar tendon and then, you know, he ended up ending his season as the result of the tear.

As far as coding for this type of injury, orthopedic medical coding involves the use of specific ICD-10 codes to document any such conditions. Codes can be found starting in the M76.5 area of your ICD-10 block. ICD-10 codes for patellar tendonitis also require a fifth character. These characters allow coders to report more specific details about the encounter and which knee it occurred to. As always, unspecific codes should be avoided. For a complete list of the codes associated with patellar tendonitis, please see the transcript below. I hope this helps, but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you so much for joining me and stay tuned for my next podcast!

Thank you!