ICD Code M19.91

ICD code M19.91 is primary osteoarthritis at an unspecified site.

1. Patient presents with chronic joint pain and stiffness not attributable to a specific injury or inflammatory condition

2. Physical examination reveals decreased range of motion, crepitus, or joint tenderness

3. Imaging studies (e.g., X-ray) demonstrate degenerative changes such as joint space narrowing, osteophyte formation, or subchondral sclerosis

4. No evidence of secondary causes such as trauma, congenital disorders, or metabolic diseases

5. Symptoms are not localized to a specific joint or site, or the affected site is not specified in the clinical documentation

6. Absence of systemic symptoms such as fever, significant swelling, or redness that would suggest an inflammatory arthropathy

Relevant CPT codes that may be used to treat ICD code M19.91 include:

- 20610: Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa)

- 20611: Arthrocentesis, aspiration and/or injection, major joint or bursa with ultrasound guidance

- 99213–99215: Office or other outpatient visit for the evaluation and management of an established patient

- 73560: Radiologic examination, knee; one or two views (example for imaging)

- 97035: Application of a modality to one or more areas; ultrasound

- 97110: Therapeutic exercises to develop strength and endurance, range of motion, and flexibility

- 27279: Arthroplasty, hip, resurfacing, femoral and acetabular, with or without femoral head resurfacing

- 27447: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

Selection of CPT codes should be based on the specific treatment rendered for M19.91.

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