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ICD-10 Guide
ICD-10 CodesM21.5

M21.5

Billable

Acquired clawhand, clubhand, clawfoot and clubfoot

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

Code Description

ICD-10 M21.5 is a billable code used to indicate a diagnosis of acquired clawhand, clubhand, clawfoot and clubfoot.

Key Diagnostic Point:

Acquired clawhand, clubhand, clawfoot, and clubfoot are deformities that develop due to various factors, including neurological conditions, trauma, or other underlying health issues. Clawhand is characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, leading to a claw-like appearance of the hand. Clubhand refers to a congenital or acquired deformity where the wrist is bent towards the body, often associated with underdeveloped bones. Clawfoot and clubfoot are similar deformities affecting the feet, where clawfoot presents with toes that are curled and clubfoot involves the foot being twisted out of shape or position. These conditions can significantly impact mobility and functionality, necessitating corrective procedures such as tendon releases, osteotomies, or the use of orthotic devices. Early diagnosis and intervention are crucial for optimal outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (neurological, traumatic, congenital)
  • Differentiation between similar deformities (e.g., clawhand vs. clubhand)
  • Potential for multiple co-existing conditions
  • Need for detailed documentation of clinical findings

Audit Risk Factors

  • Inadequate documentation of the specific deformity type
  • Failure to document the underlying cause of the deformity
  • Incorrect coding of associated conditions
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed descriptions of the deformity, treatment plans, and outcomes.

Common Clinical Scenarios

Patients presenting with hand or foot deformities requiring surgical intervention.

Billing Considerations

Ensure that all relevant imaging and diagnostic tests are documented.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and rehabilitation plans must be clearly outlined.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery for deformity correction.

Billing Considerations

Document the patient's progress and any modifications to the rehabilitation plan.

Coding Guidelines

Inclusion Criteria

Use M21.5 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the deformity type and any associated conditions
  • Include details about the onset and underlying causes

Exclusion Criteria

Do NOT use M21.5 When
  • Exclude congenital deformities unless specified as acquired

Related ICD-10 Codes

Related CPT Codes

28285CPT Code

Osteotomy, metatarsal, for hallux valgus

Clinical Scenario

Used in conjunction with M21.5 when correcting hallux valgus associated with clawfoot.

Documentation Requirements

Document the specific procedure performed and the rationale for surgery.

Specialty Considerations

Orthopedic surgeons should provide detailed operative notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the accuracy of data collection and reimbursement processes. M21.5 provides a clear classification for acquired conditions that were previously less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the accuracy of data collection and reimbursement processes. M21.5 provides a clear classification for acquired conditions that were previously less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. M21.5 provides a clear classification for acquired conditions that were previously less defined in ICD-9.

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 clawhand and clubhand?

Clawhand involves hyperextension of the fingers and flexion at the joints, while clubhand refers to a deformity where the wrist is bent towards the body, often with underdeveloped bones.