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ICD-10 Guide
ICD-10 CodesM21.1

M21.1

Billable

Varus deformity, not elsewhere classified

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

Code Description

ICD-10 M21.1 is a billable code used to indicate a diagnosis of varus deformity, not elsewhere classified.

Key Diagnostic Point:

Varus deformity refers to a condition where a limb or joint is angled inward, resulting in a bowing appearance. This deformity can occur in various parts of the body, including the knees, elbows, and toes. In the context of acquired deformities, varus deformities can arise due to conditions such as osteoarthritis, trauma, or developmental issues. Finger and toe abnormalities, including hallux valgus (bunion), can also be associated with varus deformities, where the alignment of the digits is altered, leading to functional impairment and discomfort. Corrective procedures may include osteotomy, where the bone is cut and realigned, or arthrodesis, which fuses the joint to correct the deformity. Accurate coding of varus deformity is essential for appropriate treatment planning and reimbursement, as it often requires a multidisciplinary approach involving orthopedic surgeons, physical therapists, and podiatrists.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of presentations and locations of the deformity
  • Differentiation from similar conditions (e.g., valgus deformities)
  • Need for detailed clinical documentation to support the diagnosis
  • Potential for co-morbid conditions affecting treatment

Audit Risk Factors

  • Inadequate documentation of the deformity's specifics
  • Failure to link the deformity to a clinical condition
  • Incorrect coding of associated procedures
  • Lack of follow-up documentation post-correction

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with knee varus deformity due to osteoarthritis requiring surgical intervention.

Billing Considerations

Ensure that the documentation specifies the location and severity of the deformity for accurate coding.

Podiatry

Documentation Requirements

Foot examination findings, including alignment and functional assessment.

Common Clinical Scenarios

Patients with hallux varus presenting for corrective surgery.

Billing Considerations

Document any conservative treatments attempted prior to surgical intervention.

Coding Guidelines

Inclusion Criteria

Use M21.1 When
  • Follow official ICD
  • CM guidelines for coding musculoskeletal conditions
  • Ensure that the diagnosis is supported by clinical documentation, including the nature of the deformity and any associated conditions

Exclusion Criteria

Do NOT use M21.1 When
  • Exclude conditions that are specifically classified elsewhere

Related ICD-10 Codes

Related CPT Codes

28300CPT Code

Osteotomy, metatarsal, for hallux valgus

Clinical Scenario

Used in conjunction with M21.1 when correcting hallux varus.

Documentation Requirements

Document the indication for surgery and pre-operative assessments.

Specialty Considerations

Orthopedic surgeons should ensure that the deformity is well documented to justify the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of varus deformities, improving the accuracy of diagnoses and treatment planning. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of varus deformities, improving the accuracy of diagnoses and treatment planning. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of varus deformities, improving the accuracy of diagnoses and treatment planning. This specificity aids in better tracking of outcomes and resource allocation.

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 varus and valgus deformities?

Varus deformities involve inward angulation of the limb or joint, while valgus deformities involve outward angulation. Accurate coding requires understanding these distinctions.