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ICD-10 Guide
ICD-10 CodesM21.869

M21.869

Billable

Other specified acquired deformities of unspecified lower leg

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

Code Description

ICD-10 M21.869 is a billable code used to indicate a diagnosis of other specified acquired deformities of unspecified lower leg.

Key Diagnostic Point:

M21.869 refers to acquired deformities of the lower leg that do not fall into more specific categories. These deformities can arise from various causes, including trauma, surgery, or underlying medical conditions. Common examples include deformities resulting from previous fractures that healed improperly, post-surgical changes, or conditions such as arthritis that lead to joint deformities. The lower leg encompasses the area between the knee and the ankle, and deformities can affect the tibia, fibula, or surrounding soft tissues. Symptoms may include pain, limited mobility, and changes in gait. Treatment often involves physical therapy, orthotic devices, or surgical interventions to correct the deformity and restore function. Accurate coding requires a thorough understanding of the patient's history and the specific nature of the deformity, as well as any associated conditions that may complicate the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes for deformities
  • Need for detailed patient history to determine the nature of the deformity
  • Differentiation from congenital deformities and other specified codes
  • Potential for multiple co-existing conditions affecting the lower leg

Audit Risk Factors

  • Inadequate documentation of the deformity's cause
  • Failure to specify the exact location of the deformity
  • Misclassification of acquired deformities as congenital
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed descriptions of the deformity, including measurements and functional limitations.

Common Clinical Scenarios

Post-fracture deformities, post-surgical changes, and degenerative joint disease.

Billing Considerations

Ensure that all relevant imaging and diagnostic tests are documented to support the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments and treatment plans that address the impact of the deformity on daily activities.

Common Clinical Scenarios

Rehabilitation following corrective surgery or management of chronic pain due to deformities.

Billing Considerations

Focus on the patient's functional status and goals for rehabilitation.

Coding Guidelines

Inclusion Criteria

Use M21.869 When
  • According to ICD
  • 10 guidelines, M21
  • 869 should be used when the specific type of acquired deformity is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that the deformity is not due to congenital factors

Exclusion Criteria

Do NOT use M21.869 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

28485CPT Code

Osteotomy, tibia and/or fibula

Clinical Scenario

Used for surgical correction of lower leg deformities.

Documentation Requirements

Operative reports detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons must document pre-operative assessments and post-operative 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 deformities, improving the ability to capture the complexity of these conditions and their treatment.

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.

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.

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 are included under M21.869?

M21.869 includes various acquired deformities of the lower leg that do not fit into more specific categories, such as those resulting from trauma, surgery, or chronic conditions.