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v1.0.0
ICD-10 Guide
ICD-10 CodesQ72.21

Q72.21

Billable

Congenital absence of both lower leg and foot, right lower limb

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

Code Description

ICD-10 Q72.21 is a billable code used to indicate a diagnosis of congenital absence of both lower leg and foot, right lower limb.

Key Diagnostic Point:

Congenital absence of both the lower leg and foot on the right side is a significant limb reduction defect that occurs during fetal development. This condition can arise from various factors, including genetic predispositions, environmental influences, or teratogenic exposures during pregnancy. Clinically, it presents as the complete absence of the right lower leg and foot, which can lead to functional limitations and challenges in mobility. Children with this condition may require multidisciplinary care, including orthopedic interventions, prosthetic fitting, and physical therapy to enhance mobility and independence. The absence of the limb can also be associated with other congenital anomalies, necessitating thorough evaluation and management. Early intervention is crucial to optimize developmental outcomes and support the child’s physical and psychosocial well-being.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other limb reduction defects
  • Potential association with syndromic conditions
  • Need for comprehensive documentation of associated anomalies
  • Variability in clinical presentation and management

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify laterality and extent of limb absence
  • Misclassification of limb reduction defects
  • Inconsistent coding across different healthcare settings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed pediatric assessments, including growth and developmental milestones, and any associated conditions.

Common Clinical Scenarios

Evaluation of a newborn with limb reduction defects, follow-up visits for prosthetic fitting, and physical therapy assessments.

Billing Considerations

Consideration of psychosocial impacts on the child and family, as well as the need for ongoing support and resources.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of limb reduction defects and evaluation for potential syndromic conditions.

Billing Considerations

Understanding the genetic basis of limb reduction defects and the implications for family planning.

Coding Guidelines

Inclusion Criteria

Use Q72.21 When
  • Follow ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's specifics, including laterality and associated anomalies
  • Use additional codes as necessary to capture any related conditions

Exclusion Criteria

Do NOT use Q72.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27599CPT Code

Unlisted procedure, leg

Clinical Scenario

Used when performing a unique surgical procedure related to limb absence.

Documentation Requirements

Detailed operative notes and rationale for the procedure.

Specialty Considerations

Orthopedic surgeons should provide comprehensive documentation to support the necessity of the procedure.

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. This specificity aids in better understanding the prevalence and management of congenital limb defects.

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. This specificity aids in better understanding the prevalence and management of congenital limb defects.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better understanding the prevalence and management of congenital limb defects.

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 Q72.21?

Documentation must include a clear diagnosis of congenital absence of the right lower leg and foot, any associated congenital anomalies, and details of the clinical evaluation and management plan.