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v1.0.0
ICD-10 Guide
ICD-10 CodesQ72.01

Q72.01

Billable

Congenital complete absence of right lower limb

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q72.01 is a billable code used to indicate a diagnosis of congenital complete absence of right lower limb.

Key Diagnostic Point:

Congenital complete absence of the right lower limb, classified under Q72.01, refers to a condition where the right leg is entirely missing from birth. This condition can arise from various developmental anomalies during gestation, often linked to genetic factors or environmental influences. The absence of a limb can significantly impact a child's mobility, development, and psychosocial well-being. Children with this condition may require multidisciplinary care, including orthopedic interventions, prosthetic fitting, and physical therapy to enhance mobility and function. The absence of the limb may also be associated with other congenital malformations, necessitating comprehensive evaluation and management. Early intervention is crucial to optimize developmental outcomes and support the child and family in adapting to the challenges posed by this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in associated congenital conditions
  • Need for detailed documentation of limb absence
  • Potential for co-existing musculoskeletal anomalies
  • Differentiation from other limb reduction defects

Audit Risk Factors

  • Inadequate documentation of limb absence
  • Failure to report associated congenital anomalies
  • Misclassification of limb reduction defects
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the limb absence, any associated conditions, and the impact on the child's development and mobility.

Common Clinical Scenarios

Common scenarios include initial diagnosis at birth, follow-up assessments for mobility, and interventions such as prosthetic fitting.

Billing Considerations

Considerations include the need for ongoing developmental assessments and coordination with physical therapy services.

Genetics

Documentation Requirements

Genetic documentation should include family history, potential syndromic associations, and results from genetic testing if applicable.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families, evaluation for syndromic conditions, and discussions about recurrence risks.

Billing Considerations

Considerations include the importance of identifying any chromosomal abnormalities that may be associated with limb absence.

Coding Guidelines

Inclusion Criteria

Use Q72.01 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific anatomical site and type of malformation
  • Documentation must clearly indicate the absence of the limb and any associated conditions

Exclusion Criteria

Do NOT use Q72.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27599CPT Code

Unlisted procedure on the femur

Clinical Scenario

Used for surgical interventions related to limb absence.

Documentation Requirements

Documentation must specify the nature of the procedure and its relation to limb absence.

Specialty Considerations

Orthopedic specialists should provide detailed operative notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital limb absence.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital limb absence.

Reimbursement & Billing Impact

reimbursement processes for congenital limb absence.

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 documentation is required for coding Q72.01?

Documentation must include a clear description of the limb absence, any associated congenital anomalies, and the impact on the child's development and mobility. Additionally, any interventions or treatments related to the condition should be documented.