Congenital malformations and deformations of the musculoskeletal system

Historical Changes

• •FY 2025: Routine maintenance updates with minor terminology clarifications
• •FY 2024: Enhanced specificity requirements for certain code ranges
• •FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

• •Proposed updates pending review by Coordination and Maintenance Committee
• •Under consideration: Enhanced digital health integration codes

Implementation Guidance

• •Review all FY 2026 updates for Q70-Q79 codes before implementation
• •Always verify the most current codes in the ICD-10-CM manual
• •Ensure clinical documentation supports the selected diagnosis codes
• +3 more guidance items...

Key Usage Points:

• •Always code to the highest level of specificity.
• •Use additional codes to identify any associated conditions.
• •When coding for inpatient care, use the code for the condition that is most resource intensive.
• •For outpatient care, code the reason for the visit as primary.
• •Remember to code any additional findings that do not meet the definition of an additional diagnosis.

When to Use:

• ✓When a patient is diagnosed with a congenital musculoskeletal deformity.
• ✓When a patient's congenital musculoskeletal condition is the reason for outpatient care.
• ✓When a patient's congenital musculoskeletal condition is the most resource intensive during inpatient care.
• ✓When a patient has a congenital musculoskeletal condition as a secondary diagnosis that impacts treatment.

When NOT to Use:

• ✗When a patient has a musculoskeletal condition that is not congenital.
• ✗When a patient's congenital musculoskeletal condition is not relevant to the current phase of treatment.
• ✗When a patient's congenital musculoskeletal condition does not impact the treatment plan.
• ✗When a patient's musculoskeletal condition is due to an injury or trauma, not a congenital defect.

Common Documentation Errors:

• ⚠Not specifying the location of the malformation or deformation
• ⚠Not documenting associated conditions or complications
• ⚠Not documenting the treatment plan