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ICD-10 Guide
ICD-10 CodesM20.11

M20.11

Billable

Hallux valgus (acquired), right foot

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M20.11 is a billable code used to indicate a diagnosis of hallux valgus (acquired), right foot.

Key Diagnostic Point:

Hallux valgus, commonly referred to as a bunion, is an acquired deformity characterized by lateral deviation of the great toe (hallux) at the metatarsophalangeal joint. This condition often results from a combination of genetic predisposition, improper footwear, and biomechanical factors. Patients may present with pain, swelling, and redness at the site of the bunion, which can lead to difficulty in walking and wearing shoes. The deformity can progress over time, causing further misalignment of the toes and potential development of secondary conditions such as metatarsalgia or hammertoe. Treatment options vary from conservative measures, such as orthotics and anti-inflammatory medications, to surgical interventions aimed at realigning the toe and alleviating pain. Surgical procedures may include osteotomy, exostectomy, or arthrodesis, depending on the severity of the deformity and the patient's overall health. Accurate coding of hallux valgus is essential for proper reimbursement and to reflect the complexity of the condition and its management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the condition
  • Need for detailed documentation of symptoms and treatment history
  • Potential for multiple surgical procedures and follow-up care
  • Differentiation from other toe deformities and conditions

Audit Risk Factors

  • Inadequate documentation of the condition's severity
  • Failure to document conservative treatment attempts before surgery
  • Incorrect coding of associated conditions or complications
  • Lack of clarity in the surgical procedure performed

Specialty Focus

Medical Specialties

Podiatry

Documentation Requirements

Detailed clinical notes on the patient's history, physical examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with pain and deformity in the great toe, requiring evaluation for surgical intervention.

Billing Considerations

Ensure documentation reflects the acquired nature of the deformity and any prior conservative treatments attempted.

Orthopedics

Documentation Requirements

Comprehensive assessment of foot mechanics, imaging studies, and surgical notes if applicable.

Common Clinical Scenarios

Patients with advanced hallux valgus requiring surgical correction or those with associated foot deformities.

Billing Considerations

Document any co-existing foot conditions that may affect treatment and coding.

Coding Guidelines

Inclusion Criteria

Use M20.11 When
  • According to ICD
  • CM guidelines, M20
  • 11 should be used when the condition is specifically acquired and affects the right foot
  • It is important to document the nature of the deformity and any associated symptoms or complications

Exclusion Criteria

Do NOT use M20.11 When
  • Exclusions include congenital forms of hallux valgus

Related ICD-10 Codes

Related CPT Codes

28292CPT Code

Osteotomy, first metatarsal

Clinical Scenario

Used for surgical correction of hallux valgus when conservative treatments fail.

Documentation Requirements

Surgical notes detailing the procedure, indications, and post-operative care.

Specialty Considerations

Podiatrists and orthopedic surgeons should ensure clear documentation of the surgical approach and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hallux valgus, improving the ability to capture the nuances of acquired versus congenital conditions. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hallux valgus, improving the ability to capture the nuances of acquired versus congenital conditions. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hallux valgus, improving the ability to capture the nuances of acquired versus congenital conditions. This specificity aids in better tracking of treatment outcomes and resource allocation.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Frequently Asked Questions

What are the common treatments for hallux valgus?

Common treatments include conservative measures such as orthotics, physical therapy, and anti-inflammatory medications. If these fail, surgical options like osteotomy or exostectomy may be considered.