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v1.0.0
ICD-10 Guide
ICD-10 CodesQ76.42

Q76.42

Billable

Congenital lordosis

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

Code Description

ICD-10 Q76.42 is a billable code used to indicate a diagnosis of congenital lordosis.

Key Diagnostic Point:

Congenital lordosis is a spinal deformity characterized by an excessive inward curvature of the lumbar spine, which can be present at birth or develop shortly thereafter. This condition may result from various factors, including genetic predispositions, intrauterine positioning, or associated congenital malformations. In pediatric patients, congenital lordosis can lead to significant functional limitations, discomfort, and potential complications such as nerve compression or altered gait patterns. Diagnosis typically involves clinical examination and imaging studies, such as X-rays or MRI, to assess the degree of curvature and rule out associated anomalies. Treatment options may vary from observation in mild cases to physical therapy, bracing, or surgical intervention in more severe instances. Early identification and management are crucial to optimize outcomes and prevent long-term complications associated with this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of lordosis
  • Potential association with other congenital malformations
  • Need for precise documentation of curvature measurements
  • Differentiation from acquired forms of lordosis

Audit Risk Factors

  • Inadequate documentation of curvature measurements
  • Failure to document associated congenital conditions
  • Incorrect coding of severity or type of lordosis
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation should include detailed clinical findings, imaging results, and treatment plans. Growth and developmental assessments are also critical.

Common Clinical Scenarios

Pediatric patients presenting with back pain, abnormal gait, or developmental delays may require evaluation for congenital lordosis.

Billing Considerations

Consideration of family history and potential genetic syndromes associated with spinal deformities is essential for accurate coding.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations should be documented to support the diagnosis.

Common Clinical Scenarios

Patients with congenital lordosis may be evaluated for genetic syndromes such as Marfan syndrome or Ehlers-Danlos syndrome.

Billing Considerations

Understanding the genetic basis of associated conditions can aid in comprehensive coding and management.

Coding Guidelines

Inclusion Criteria

Use Q76.42 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific malformation and any associated conditions
  • Documentation must support the diagnosis and any treatments provided

Exclusion Criteria

Do NOT use Q76.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22558CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in cases of severe congenital lordosis requiring surgical intervention.

Documentation Requirements

Pre-operative assessments, imaging studies, and post-operative follow-up notes.

Specialty Considerations

Orthopedic and pediatric surgical specialties should collaborate for comprehensive care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes.

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 difference between congenital lordosis and acquired lordosis?

Congenital lordosis is present at birth and may be associated with other congenital anomalies, while acquired lordosis develops later due to factors such as injury, obesity, or muscle imbalances. Accurate coding requires clear documentation of the condition's origin.