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ICD-10 Guide
ICD-10 CodesM21.94

M21.94

Billable

Unspecified acquired deformity of hand

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

Code Description

ICD-10 M21.94 is a billable code used to indicate a diagnosis of unspecified acquired deformity of hand.

Key Diagnostic Point:

Unspecified acquired deformity of the hand refers to a condition characterized by structural abnormalities of the hand that develop due to various factors such as trauma, disease, or other external influences. Unlike congenital deformities, which are present at birth, acquired deformities can arise from conditions such as arthritis, fractures, or repetitive stress injuries. These deformities may manifest as changes in the shape, alignment, or function of the fingers or hand as a whole. Common examples include malalignment of the fingers, loss of range of motion, and changes in grip strength. The specific nature of the deformity can vary widely, making it essential for healthcare providers to document the underlying cause and the specific characteristics of the deformity. Treatment options may include physical therapy, splinting, or surgical interventions aimed at restoring function and alleviating pain. Accurate coding is crucial for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and underlying causes of deformities
  • Need for detailed documentation to specify the nature of the deformity
  • Differentiation from congenital deformities and other related codes
  • Potential for multiple underlying conditions contributing to the deformity

Audit Risk Factors

  • Insufficient documentation of the deformity's cause
  • Lack of specificity in describing the deformity
  • Inconsistent coding with clinical findings
  • Failure to document treatment plans or outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with post-traumatic deformities, arthritis-related changes, or repetitive strain injuries.

Billing Considerations

Documentation should include the specific joints or fingers affected and any functional limitations.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for hand function post-injury or surgery.

Billing Considerations

Focus on the impact of the deformity on daily activities and the effectiveness of rehabilitation interventions.

Coding Guidelines

Inclusion Criteria

Use M21.94 When
  • According to ICD
  • 10 guidelines, M21
  • 94 should be used when the specific type of acquired deformity is not documented
  • Coders should ensure that the documentation supports the use of this code and that it is not used when a more specific code is available

Exclusion Criteria

Do NOT use M21.94 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

26145CPT Code

Arthroplasty, finger joint

Clinical Scenario

Used when surgical correction of a finger deformity is performed.

Documentation Requirements

Operative reports detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons should document the specific deformity and its functional implications.

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 granularity of data for treatment outcomes and reimbursement. M21.94 provides a catch-all for unspecified deformities, but coders must ensure accurate documentation to avoid audit issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the granularity of data for treatment outcomes and reimbursement. M21.94 provides a catch-all for unspecified deformities, but coders must ensure accurate documentation to avoid audit issues.

Reimbursement & Billing Impact

reimbursement. M21.94 provides a catch-all for unspecified deformities, but coders must ensure accurate documentation to avoid audit issues.

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 should I document to support the use of M21.94?

Document the specific characteristics of the deformity, its cause, and any functional limitations it imposes on the patient. Include treatment plans and outcomes to provide a comprehensive view of the patient's condition.