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ICD-10 Guide
ICD-10 CodesQ72.891

Q72.891

Billable

Other reduction defects of right lower limb

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

Code Description

ICD-10 Q72.891 is a billable code used to indicate a diagnosis of other reduction defects of right lower limb.

Key Diagnostic Point:

Q72.891 refers to congenital malformations characterized by the partial or complete absence of one or more structures in the right lower limb. These defects can arise from genetic factors, environmental influences, or a combination of both during fetal development. Commonly associated conditions include limb reduction defects, which may manifest as phocomelia (absence of limbs), amelia (absence of a limb), or other variations in limb length and structure. The right lower limb may exhibit abnormalities in bones, muscles, and soft tissues, leading to functional impairments. Diagnosis typically involves physical examination, imaging studies, and genetic testing to identify any underlying chromosomal abnormalities. Management may include orthopedic interventions, physical therapy, and, in some cases, surgical procedures to improve function and appearance. 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 limb defects
  • Need for comprehensive documentation of associated conditions
  • Potential for multiple coding options based on clinical findings
  • Requirement for genetic testing results in some cases

Audit Risk Factors

  • Inadequate documentation of the specific limb affected
  • Failure to include associated congenital anomalies
  • Misuse of codes for similar conditions
  • Lack of genetic testing documentation when applicable

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on the child's developmental milestones, physical examination findings, and any interventions performed.

Common Clinical Scenarios

A pediatric patient presenting with a clubfoot and limb reduction defect requiring orthopedic evaluation and treatment.

Billing Considerations

Ensure accurate coding of associated conditions, such as scoliosis or hip dysplasia, which may coexist.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

A child with a limb reduction defect undergoing genetic counseling to assess for chromosomal abnormalities.

Billing Considerations

Consider the implications of genetic syndromes that may present with limb defects, requiring careful coding.

Coding Guidelines

Inclusion Criteria

Use Q72.891 When
  • Follow ICD
  • CM guidelines for congenital malformations, ensuring specificity in coding based on the affected limb and associated conditions
  • Document all relevant clinical findings and interventions

Exclusion Criteria

Do NOT use Q72.891 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27570CPT Code

Amputation, leg, below knee

Clinical Scenario

Used in cases where limb reduction defects require surgical intervention.

Documentation Requirements

Document the indication for surgery and any preoperative assessments.

Specialty Considerations

Orthopedic specialists should ensure accurate coding based on the surgical procedure performed.

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 malformations.

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 malformations.

Reimbursement & Billing Impact

reimbursement processes for congenital malformations.

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 needed for coding Q72.891?

Comprehensive documentation should include a detailed clinical description of the limb defect, any associated congenital anomalies, results from imaging studies, and genetic testing if applicable. Ensure that the specific limb affected is clearly identified.