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 Q80-Q89 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:

• •These codes are used for conditions present at birth, not acquired conditions.
• •Each code specifies the particular malformation or deformation.
• •Some codes require additional codes to fully describe the condition.
• •These codes can be used across many medical specialties.
• •Documentation must clearly indicate the condition is congenital.

When to Use:

• ✓When a patient presents with a congenital musculoskeletal condition.
• ✓When a congenital musculoskeletal condition is discovered during a routine examination.
• ✓When a congenital musculoskeletal condition is relevant to the patient's current medical treatment.
• ✓When a congenital musculoskeletal condition affects the patient's health status.

When NOT to Use:

• ✗When the condition is acquired, not congenital.
• ✗When the condition is not related to the musculoskeletal system.
• ✗When the condition is a normal variant, not a malformation or deformation.
• ✗When the condition is better described by another code.

Common Documentation Errors:

• ⚠Not specifying the condition is congenital
• ⚠Not providing enough detail about the malformation or deformation
• ⚠Not documenting related conditions or complications
• ⚠Not including supporting evidence