M17.4: Other bilateral secondary osteoarthritis of knee
M17.4, other bilateral secondary osteoarthritis of knee, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 87 HCPCS Level II codes, including J7328 (Hyaluronan or derivative, gelsyn-3, for intra-articular…), J7318 (Hyaluronan or derivative, durolane, for intra-articular…), J7325 (Hyaluronan or derivative, synvisc or synvisc-one, for…). 47 of these codes have a 2026 DMEPOS fee schedule amount; L1844 pays $1,865.51 to $2,436.24 depending on the state. The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M17.4 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J7328 | Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg | Carrier judgment | — | 3 |
| J7318 | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7322 | Hyaluronan or derivative, hymovis or hymovis one, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7332 | Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7331 | Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg | Carrier judgment | — | 3 |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | Carrier judgment | — | 3 |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | Carrier judgment | — | 3 |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | Carrier judgment | — | 3 |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose | Carrier judgment | — | 3 |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | Carrier judgment | — | 3 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 2 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 2 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 2 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 2 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 2 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 2 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 3 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
62 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing M17.4
- A56157: Billing and Coding: Intraarticular Knee Injections of Hyaluronan (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L39529
- A59030: Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L39260
- A52420: Billing and Coding: Hyaluronans Intra-articular Injections of (Wellpoint Federal (MAC - Part A, MAC - Part B); 13 Level II codes)
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A60250: Billing and Coding: Total Joint Arthroplasty (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33456, L36039, L39911, L40232
- A52465: Knee Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 53 Level II codes). LCD with the same title: L33318
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M17 diagnoses (Osteoarthritis of knee)
- M17.0 — Bilateral primary osteoarthritis of knee
- M17.11 — Unilateral primary osteoarthritis, right knee
- M17.12 — Unilateral primary osteoarthritis, left knee
- M17.2 — Bilateral post-traumatic osteoarthritis of knee
- M17.31 — Unilateral post-traumatic osteoarthritis, right knee
- M17.32 — Unilateral post-traumatic osteoarthritis, left knee
- M17.5 — Other unilateral secondary osteoarthritis of knee
- M17.9 — Osteoarthritis of knee, unspecified
Frequently asked questions
Does Medicare cover M17.4 (Other bilateral secondary osteoarthritis of knee)?
Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list M17.4 as a covered diagnosis for 87 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M17.4?
The Level II codes from the policies most specific to this diagnosis are J7328 (Hyaluronan or derivative, gelsyn-3, for intra-articular…, 3 articles); J7318 (Hyaluronan or derivative, durolane, for intra-articular…, 3 articles); J7325 (Hyaluronan or derivative, synvisc or synvisc-one, for…, 3 articles); J7320 (Hyaluronan or derivitive, genvisc 850, for intra-articular…, 3 articles); J7329 (Hyaluronan or derivative, trivisc, for intra-articular…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with M17.4?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L1844 $1,865.51 to $2,436.24; L1860 $1,233.07 to $1,985.94; L1846 $1,283.72 to $1,960.17; L1834 $892.02 to $1,808.36. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list M17.4?
A56157 (Billing and Coding: Intraarticular Knee Injections of Hyaluronan); A59030 (Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis); A52420 (Billing and Coding: Hyaluronans Intra-articular Injections of), and 7 more articles.
What is ICD-10-CM code M17.4?
M17.4 is the ICD-10-CM code for other bilateral secondary osteoarthritis of knee, in category M17 (Osteoarthritis of knee), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under J7328
- Watch J7328 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7328
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup