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v1.0.0
ICD-10 Guide
ICD-10 CodesM21.85

M21.85

Billable

Other specified acquired deformities of thigh

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

Code Description

ICD-10 M21.85 is a billable code used to indicate a diagnosis of other specified acquired deformities of thigh.

Key Diagnostic Point:

Acquired deformities of the thigh can arise from various conditions, including trauma, infections, or surgical interventions. These deformities may manifest as abnormal bone growth, malalignment, or changes in the soft tissue structure surrounding the thigh. Common causes include post-traumatic changes following fractures, surgical alterations from procedures such as hip replacements, or conditions like osteomyelitis that can lead to structural changes. Patients may present with symptoms such as pain, reduced mobility, and functional impairment. The deformities can affect gait and overall quality of life, necessitating a thorough assessment and potential corrective procedures. Treatment options may include physical therapy, orthotic devices, or surgical interventions aimed at restoring normal anatomy and function. Accurate coding of these deformities is crucial for appropriate management and reimbursement, as they can significantly impact patient outcomes and healthcare costs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to deformities
  • Need for detailed clinical documentation to specify the nature of the deformity
  • Potential overlap with other codes for similar conditions
  • Variability in treatment approaches and outcomes

Audit Risk Factors

  • Inadequate documentation of the deformity's cause
  • Failure to specify the anatomical location of the deformity
  • Misuse of related codes leading to incorrect billing
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Post-surgical deformities following hip or knee replacement, trauma-related deformities.

Billing Considerations

Ensure that all relevant surgical history and imaging studies are documented to support the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and treatment plans focusing on mobility and rehabilitation.

Common Clinical Scenarios

Patients undergoing rehabilitation for acquired deformities post-injury or surgery.

Billing Considerations

Document the impact of the deformity on the patient's daily activities and rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use M21.85 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the deformity is acquired and not congenital
  • Document the specific nature and cause of the deformity to support the use of this code

Exclusion Criteria

Do NOT use M21.85 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Total knee arthroplasty

Clinical Scenario

Used in cases where deformities necessitate knee replacement surgery.

Documentation Requirements

Pre-operative assessments, surgical notes, and post-operative follow-up documentation.

Specialty Considerations

Orthopedic surgeons must document the deformity's impact on function and the rationale for surgery.

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 ability to capture the complexity of these conditions and their treatment needs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the ability to capture the complexity of these conditions and their treatment needs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the ability to capture the complexity of these conditions and their treatment needs.

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 types of conditions can lead to M21.85?

M21.85 can be used for acquired deformities resulting from trauma, infections, surgical interventions, or other acquired conditions affecting the thigh.