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ICD-10 Guide
ICD-10 CodesM21.531

M21.531

Billable

Acquired clawfoot, right foot

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

Code Description

ICD-10 M21.531 is a billable code used to indicate a diagnosis of acquired clawfoot, right foot.

Key Diagnostic Point:

Acquired clawfoot, also known as claw toe, is a deformity characterized by hyperextension of the metatarsophalangeal joint and flexion of the proximal and distal interphalangeal joints of the toes. This condition can arise from various underlying causes, including neurological disorders, trauma, or muscle imbalances. In the case of acquired clawfoot of the right foot, the deformity may lead to significant functional impairment, pain, and difficulty in ambulation. Patients may experience calluses, corns, or ulcerations due to abnormal pressure distribution on the foot. The condition can be associated with other foot deformities such as hallux valgus, where the big toe deviates laterally, further complicating the clinical picture. Treatment options may include conservative measures such as orthotic devices, physical therapy, and pain management, or surgical interventions to correct the deformity and restore normal foot function. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other foot deformities like hallux valgus and hammer toes.
  • Need for detailed documentation of the underlying cause of the deformity.
  • Potential for co-existing conditions that may complicate coding.
  • Variability in clinical presentation and treatment options.

Audit Risk Factors

  • Inadequate documentation of the underlying cause of clawfoot.
  • Failure to document associated conditions or complications.
  • Incorrect assignment of laterality (right vs. left foot).
  • Lack of evidence for conservative treatment measures before surgical intervention.

Specialty Focus

Medical Specialties

Podiatry

Documentation Requirements

Detailed clinical notes including physical examination findings, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with foot pain, deformities, or difficulty walking.

Billing Considerations

Documentation should include the impact of the deformity on the patient's quality of life and any prior treatments attempted.

Orthopedics

Documentation Requirements

Comprehensive assessment of foot structure, alignment, and function, along with surgical notes if applicable.

Common Clinical Scenarios

Patients requiring surgical correction of foot deformities or those with associated musculoskeletal issues.

Billing Considerations

Ensure that all surgical interventions are clearly documented, including pre-operative and post-operative assessments.

Coding Guidelines

Inclusion Criteria

Use M21.531 When
  • According to ICD
  • 10 coding guidelines, M21
  • 531 should be used when the condition is specifically diagnosed as acquired clawfoot of the right foot
  • Coders must ensure that the documentation supports the diagnosis and includes details about the severity and impact on function

Exclusion Criteria

Do NOT use M21.531 When
  • Exclusion criteria include congenital deformities and other specified foot conditions

Related ICD-10 Codes

Related CPT Codes

28285CPT Code

Correction of claw toe deformity

Clinical Scenario

Used when surgical correction is performed for acquired clawfoot.

Documentation Requirements

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

Specialty Considerations

Podiatrists and orthopedic surgeons should ensure comprehensive documentation of the surgical approach and outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acquired clawfoot, improving the ability to capture the complexity of the condition and its treatment. This specificity aids in better tracking of outcomes and resource allocation in healthcare settings.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired clawfoot, improving the ability to capture the complexity of the condition and its treatment. This specificity aids in better tracking of outcomes and resource allocation in healthcare settings.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of acquired clawfoot, improving the ability to capture the complexity of the condition and its treatment. This specificity aids in better tracking of outcomes and resource allocation in healthcare settings.

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 acquired clawfoot and congenital clawfoot?

Acquired clawfoot develops due to external factors such as injury or disease, while congenital clawfoot is present at birth due to genetic factors or developmental issues.