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v1.0.0
ICD-10 Guide
ICD-10 CodesQ72.43

Q72.43

Billable

Longitudinal reduction defect of femur, bilateral

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

Code Description

ICD-10 Q72.43 is a billable code used to indicate a diagnosis of longitudinal reduction defect of femur, bilateral.

Key Diagnostic Point:

Longitudinal reduction defect of the femur is a congenital malformation characterized by the underdevelopment or absence of the femur bone in one or both legs. In bilateral cases, both femurs are affected, leading to significant implications for mobility and overall limb function. This condition can result from genetic factors, environmental influences, or a combination of both. Clinically, patients may present with shortened limbs, abnormal gait, and associated deformities such as hip dysplasia or scoliosis. Diagnosis typically involves imaging studies, including X-rays or MRI, to assess the extent of the defect and any associated musculoskeletal anomalies. Management may include orthopedic interventions, physical therapy, and in some cases, surgical procedures to improve limb function and alignment. Early intervention is crucial for optimizing developmental outcomes in affected children.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the defect
  • Need for detailed imaging documentation
  • Potential for associated congenital anomalies
  • Differentiation from other limb reduction defects

Audit Risk Factors

  • Inadequate documentation of the defect's severity
  • Failure to document associated conditions
  • Misclassification of limb reduction defects
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed growth and developmental assessments, including physical examinations and treatment plans.

Common Clinical Scenarios

A pediatric patient presenting with bilateral femur reduction defects requiring orthopedic evaluation and intervention.

Billing Considerations

Consideration of developmental milestones and the impact of the defect on mobility and daily activities.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations.

Common Clinical Scenarios

Referral for genetic counseling in cases of suspected syndromic congenital limb defects.

Billing Considerations

Understanding the genetic basis of limb reduction defects and their potential hereditary implications.

Coding Guidelines

Inclusion Criteria

Use Q72.43 When
  • Follow ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the defect's nature and any associated conditions
  • Use additional codes as necessary to capture related anomalies

Exclusion Criteria

Do NOT use Q72.43 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27500CPT Code

Osteotomy, femur

Clinical Scenario

Used in surgical correction of femur defects.

Documentation Requirements

Surgical notes detailing the procedure and indications.

Specialty Considerations

Orthopedic documentation must include pre-operative assessments.

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 granularity of data for research and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the granularity of data for research and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the granularity of data for research and treatment outcomes.

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 is the importance of documenting associated conditions with Q72.43?

Documenting associated conditions is crucial as it provides a comprehensive view of the patient's health status, informs treatment planning, and ensures accurate coding for reimbursement.