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v1.0.0
ICD-10 Guide
ICD-10 CodesM21.90

M21.90

Billable

Unspecified acquired deformity of unspecified limb

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

Code Description

ICD-10 M21.90 is a billable code used to indicate a diagnosis of unspecified acquired deformity of unspecified limb.

Key Diagnostic Point:

M21.90 refers to an unspecified acquired deformity of an unspecified limb, which encompasses a variety of conditions that result in structural abnormalities of the limbs due to non-congenital factors. Acquired deformities can arise from trauma, infections, inflammatory conditions, or degenerative diseases. Common examples include hallux valgus, where the big toe deviates laterally, leading to a bony prominence at the base of the toe. Other deformities may involve the fingers or toes, such as claw toes or hammer toes, which can result from muscle imbalances or nerve damage. Corrective procedures may include surgical interventions like osteotomies or arthroplasties to realign bones or joints. Accurate coding requires careful documentation of the deformity's nature, cause, and any associated symptoms or functional limitations, as these factors can influence treatment options and outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes for acquired deformities
  • Need for precise documentation of the deformity's characteristics
  • Differentiation from congenital deformities
  • Potential for multiple co-existing conditions affecting the limb

Audit Risk Factors

  • Insufficient documentation of the deformity's cause
  • Lack of specificity in describing the limb affected
  • Inconsistent use of the code across different providers
  • Failure to document associated conditions or treatments

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acquired deformities post-trauma or surgery.

Billing Considerations

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

Podiatry

Documentation Requirements

Foot examination findings, patient history, and treatment rationale.

Common Clinical Scenarios

Patients with hallux valgus or other toe deformities seeking corrective surgery.

Billing Considerations

Document the functional impact of the deformity on the patient's daily activities.

Coding Guidelines

Inclusion Criteria

Use M21.90 When
  • According to ICD
  • 10 guidelines, M21
  • 90 should be used when the specific nature of the acquired deformity is not documented
  • Coders should ensure that the documentation supports the use of this code and consider more specific codes if available

Exclusion Criteria

Do NOT use M21.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

28296CPT Code

Bunionectomy

Clinical Scenario

Performed for hallux valgus correction.

Documentation Requirements

Pre-operative assessment, imaging, and post-operative care notes.

Specialty Considerations

Orthopedic or podiatric specialties should document the rationale for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, but M21.90 remains a catch-all code that can lead to ambiguity if not supported by thorough documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, but M21.90 remains a catch-all code that can lead to ambiguity if not supported by thorough documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, but M21.90 remains a catch-all code that can lead to ambiguity if not supported by thorough documentation.

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

When should I use M21.90?

Use M21.90 when the documentation indicates an acquired deformity of a limb but does not specify the type or location. Ensure that the clinical notes support the use of this unspecified code.