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v1.0.0
ICD-10 Guide
ICD-10 CodesQ73.1

Q73.1

Billable

Phocomelia, unspecified limb(s)

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

Code Description

ICD-10 Q73.1 is a billable code used to indicate a diagnosis of phocomelia, unspecified limb(s).

Key Diagnostic Point:

Phocomelia is a congenital condition characterized by the absence or severe shortening of limbs, resulting in a flipper-like appearance. This condition can affect one or more limbs and is often associated with other congenital malformations. The etiology of phocomelia can be genetic or environmental, with teratogenic factors such as thalidomide exposure during pregnancy being a well-documented cause. Clinically, phocomelia presents with varying degrees of limb reduction defects, which may include the absence of the humerus or femur, leading to significant functional impairment. Children with phocomelia may also experience associated musculoskeletal anomalies, such as scoliosis or hip dysplasia, which can complicate their overall health management. Accurate diagnosis typically involves a combination of physical examination, imaging studies, and genetic testing to rule out associated chromosomal abnormalities. Early intervention, including physical therapy and orthopedic management, is crucial for improving mobility and quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of limb reduction defects
  • Potential for associated congenital anomalies requiring additional coding
  • Need for comprehensive documentation to support the diagnosis
  • Differentiation from other limb reduction defects and congenital conditions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the affected limb(s) when applicable
  • Misclassification of phocomelia with other limb reduction defects
  • Lack of genetic testing documentation when indicated

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes including physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Assessment of limb function, referral for orthopedic evaluation, and coordination of multidisciplinary care.

Billing Considerations

Consideration of developmental milestones and the impact of limb anomalies on growth and function.

Genetics

Documentation Requirements

Genetic testing results, family history, and risk assessment documentation.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital limb defects and evaluation for syndromic associations.

Billing Considerations

Understanding the genetic basis of phocomelia and its potential inheritance patterns.

Coding Guidelines

Inclusion Criteria

Use Q73.1 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring specificity in documentation and adherence to coding conventions for congenital conditions

Exclusion Criteria

Do NOT use Q73.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Office or other outpatient visit for the evaluation and management of an established patient

Clinical Scenario

Used for follow-up visits in patients with phocomelia for ongoing management.

Documentation Requirements

Documentation of the patient's history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should focus on developmental assessments and referrals.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track and manage congenital anomalies like phocomelia.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track and manage congenital anomalies like phocomelia.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track and manage congenital anomalies like phocomelia.

Resources

Clinical References

  • •
    CDC - Birth Defects

Coding & Billing References

  • •
    CDC - Birth Defects

Frequently Asked Questions

What is the difference between phocomelia and amelia?

Phocomelia refers to the severe shortening of limbs, while amelia is the complete absence of a limb. Accurate coding requires understanding these distinctions to ensure proper documentation and billing.