ICD-10-CM · Knee

M76.41

Inflammation or calcification of the bursa adjacent to the tibial collateral (medial collateral) ligament at the right knee, consistent with Pellegrini-Stieda syndrome.

Verified May 8, 2026 · 3 sources ↓

Status
Billable
Chapter
13
Related CPT
7
Region
Knee
Drawn from CDCICD10DataAAPC

Documentation tips

What should appear in the chart to support M76.41.

Source · Editorial brief grounded in 3 cited references ↓

  • Explicitly document laterality as 'right' — without it, payers may downcode to M76.40 (unspecified) on audit.
  • Record imaging findings that support the diagnosis: medial knee calcification on X-ray (Pellegrini-Stieda lesion), or bursal fluid/thickening on MRI or ultrasound.
  • Note whether bursitis is post-traumatic (prior MCL injury) or chronic/insidious onset — this supports the enthesopathic classification under M76 rather than M70.
  • Document conservative treatment history (NSAIDs, physical therapy, aspiration) if prior authorization is required for advanced imaging or corticosteroid injection.
  • If bilateral involvement exists, assign M76.41 and M76.42 separately — there is no single bilateral code in the M76.4 subcategory.

Related CPT procedures

Procedure codes commonly billed with M76.41. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M76.41 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Assigning M76.40 (unspecified) when the provider note clearly states 'right knee' — always capture documented laterality.
  • Coding M76.41 for a plain MCL sprain or medial knee pain without documented bursitis; this code requires a confirmed bursitis or Pellegrini-Stieda diagnosis.
  • Defaulting to M70 bursitis codes when the mechanism is enthesopathic rather than strictly occupational pressure — review the Excludes2 note at M76 carefully before switching categories.
  • Missing a concurrent diagnosis code when calcification is the primary finding — consider whether additional coding for soft-tissue calcification is warranted based on provider documentation.

Clinical context

Source · Editorial summary grounded in 3 cited references ↓

M76.41 captures tibial collateral bursitis — also called Pellegrini-Stieda syndrome — specifically affecting the right leg. The condition involves pathologic changes (inflammation, calcification, or both) at the bursa overlying the medial collateral ligament of the right knee. It commonly follows prior medial knee trauma or chronic overuse stress to the MCL insertion and presents with medial knee pain, tenderness directly over the tibial collateral ligament, and characteristic calcification visible on plain radiograph.

Use M76.41 when the provider explicitly documents right-sided tibial collateral bursitis or Pellegrini-Stieda disease of the right knee. If laterality is not documented, fall back to M76.40 (unspecified leg). For confirmed left-leg involvement, use M76.42. Do not assign M76.41 for general medial knee pain or MCL sprain — the diagnosis requires bursitis at the tibial collateral ligament, supported by clinical exam and/or imaging.

Two important Excludes2 notes apply at the M76 category level: bursitis due to use, overuse, and pressure (M70.-) is excluded, as is enthesopathy of the ankle and foot (M77.5-). If the bursitis is attributed explicitly to occupational or pressure-related overuse rather than the enthesopathic mechanism, evaluate M70 codes instead. MS-DRG grouping lands in DRG 557 (with MCC) or DRG 558 (without MCC) under Tendonitis, Myositis and Bursitis.

Sibling codes

Other billable codes under M76.4 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01What is Pellegrini-Stieda syndrome and how does it differ from standard MCL bursitis?
Pellegrini-Stieda syndrome specifically refers to calcification at the tibial collateral ligament, typically following prior medial knee trauma. M76.41 covers both the calcific and inflammatory presentations at the right tibial collateral bursa under the same code.
02Can I use M76.41 if the provider only documents 'medial knee bursitis' without naming Pellegrini-Stieda?
Yes, if the location is the tibial (medial) collateral ligament bursa of the right knee. The Pellegrini-Stieda eponym is bracketed as an alternative name — anatomic specificity in the note is sufficient to assign M76.41.
03Which code do I use for bilateral tibial collateral bursitis?
Assign M76.41 (right) and M76.42 (left) together. There is no single bilateral code in the M76.4 subcategory; both laterality-specific codes must be reported.
04When should I use M70 instead of M76.41 for knee bursitis?
The M76 Excludes2 note points to M70 for bursitis attributed to use, overuse, and pressure — think occupational or repetitive-pressure etiology. If the bursitis is tied to the enthesopathic mechanism at the MCL, M76.41 is correct.
05Is M76.41 valid for an outpatient injection claim?
Yes. M76.41 is a billable, specific code effective since FY2016 and valid for outpatient encounters, including corticosteroid injections billed with CPT 20610.
06What DRG does M76.41 map to on inpatient claims?
M76.41 groups to MS-DRG 557 (Tendonitis, Myositis and Bursitis with MCC) or MS-DRG 558 (without MCC) under MS-DRG v43.0.
07Does M76.41 require a 7th-character extension?
No. M76.41 is a 5-character M-code with no 7th-character extension requirement. 7th characters (A/D/S) apply to injury S-codes, not musculoskeletal M-codes.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
  2. 02
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M76-/M76.41
  3. 03
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M76.41

Mira AI Scribe

Mira AI Scribe captures the documented side (right), the clinical finding (medial knee tenderness at the tibial collateral ligament), any imaging evidence of calcification or bursal swelling, and prior trauma or overuse history — the elements that lock in M76.41 over the unspecified M76.40 and prevent a payer downcode or specificity audit flag.

See how Mira captures M76.41 documentation

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