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v1.0.0
ICD-10 Guide
ICD-10 CodesM21.00

M21.00

Billable

Valgus deformity, not elsewhere classified, unspecified site

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

Code Description

ICD-10 M21.00 is a billable code used to indicate a diagnosis of valgus deformity, not elsewhere classified, unspecified site.

Key Diagnostic Point:

Valgus deformity refers to a condition where a body part is turned outward away from the midline of the body. This code specifically addresses acquired valgus deformities that are not classified elsewhere, and it can occur in various joints, including fingers and toes. Common examples include hallux valgus, where the big toe deviates laterally, leading to a prominent bunion. Acquired deformities can result from various factors, including trauma, arthritis, or repetitive stress. The condition can lead to pain, difficulty in movement, and secondary complications such as osteoarthritis. Corrective procedures may include conservative management like orthotics and physical therapy, or surgical interventions such as osteotomy or arthrodesis, depending on the severity and impact on function. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking the prevalence of these deformities in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (trauma, arthritis, etc.)
  • Differentiation from other deformities (e.g., varus deformity)
  • Need for precise documentation of site and severity
  • Potential for multiple co-existing conditions

Audit Risk Factors

  • Insufficient documentation of the deformity's nature and site
  • Lack of clarity on whether the deformity is congenital or acquired
  • Inconsistent coding of related procedures
  • Failure to document co-existing conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed descriptions of the deformity, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with foot pain, bunions, or joint deformities requiring surgical evaluation.

Billing Considerations

Ensure to document the functional impact of the deformity on the patient's daily activities.

Podiatry

Documentation Requirements

Foot examination findings, patient history, and conservative treatment attempts.

Common Clinical Scenarios

Patients with hallux valgus seeking conservative management or surgical options.

Billing Considerations

Document any orthotic interventions and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use M21.00 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the deformity's site and nature
  • Include any relevant history of trauma or underlying conditions
  • Use additional codes for associated conditions as necessary

Exclusion Criteria

Do NOT use M21.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

28296CPT Code

Bunionectomy

Clinical Scenario

Performed for severe hallux valgus deformity.

Documentation Requirements

Pre-operative assessment, imaging, and surgical notes.

Specialty Considerations

Orthopedic or podiatric specialties may have specific protocols for bunion surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformities, improving data accuracy and treatment tracking. M21.00 provides a broad classification for acquired cases, which can help in identifying trends in treatment and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformities, improving data accuracy and treatment tracking. M21.00 provides a broad classification for acquired cases, which can help in identifying trends in treatment and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformities, improving data accuracy and treatment tracking. M21.00 provides a broad classification for acquired cases, which can help in identifying trends in treatment and outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between M21.00 and M21.01?

M21.00 is used for unspecified valgus deformities, while M21.01 specifically refers to hallux valgus of the right foot.