ICD Code M67.50

ICD code M6750 is used to identify and classify the medical condition known as plica syndrome in an unspecified knee. Plica syndrome occurs when the plica, a fold in the thin tissue lining the knee joint, becomes irritated or inflamed. This can lead to knee pain, swelling, and discomfort, often exacerbated by physical activity. The "unspecified knee" designation indicates that the documentation does not specify whether the condition affects the left or right knee. This code is essential for healthcare providers to accurately document the diagnosis for billing, treatment planning, and statistical purposes.

When to use the ICD code for Plica syndrome, unspecified knee:

1. Presence of Knee Pain
- Patient reports localized pain in the knee joint.

2. Swelling or Inflammation
- Observation of swelling around the knee area, indicating possible inflammation.

3. Limited Range of Motion
- Patient experiences difficulty or discomfort when attempting to fully extend or flex the knee.

4. Clicking or Popping Sensation
- Patient describes audible sounds or sensations during knee movement, particularly when bending or straightening the knee.

5. History of Knee Trauma
- Patient has a documented history of knee injury or overuse that may contribute to the development of plica syndrome.

6. Exclusion of Other Conditions
- Differential diagnosis has ruled out other potential causes of knee pain, such as ligament injuries, meniscus tears, or osteoarthritis.

7. Physical Examination Findings
- Clinical examination reveals tenderness along the medial or lateral aspect of the knee, particularly over the plica.

8. Imaging Studies
- MRI or ultrasound findings suggest the presence of a plica or other abnormalities consistent with plica syndrome.

9. Response to Conservative Treatment
- Patient has not responded to conservative management strategies, such as rest, ice, compression, and elevation (RICE), or physical therapy.

10. Chronic Symptoms
- Symptoms have persisted for an extended period, typically beyond a few weeks, indicating a chronic condition.

For the ICD code M67.50, which pertains to plica syndrome of an unspecified knee, the relevant CPT codes that may be applicable for treatment include:

1. 29870 - Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure).

2. 29875 - Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate procedure).

3. 29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral).

4. 29877 - Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty).

These CPT codes are commonly used in the context of arthroscopic procedures that may be performed to address issues related to plica syndrome. It is important for healthcare providers to verify the specific procedures performed and ensure accurate coding for proper reimbursement.

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