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v1.0.0
ICD-10 Guide
ICD-10 CodesQ76.425

Q76.425

Billable

Congenital lordosis, thoracolumbar region

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

Code Description

ICD-10 Q76.425 is a billable code used to indicate a diagnosis of congenital lordosis, thoracolumbar region.

Key Diagnostic Point:

Congenital lordosis in the thoracolumbar region is characterized by an abnormal anterior curvature of the spine that is present at birth. This condition can lead to significant postural abnormalities and may affect the overall musculoskeletal development of the child. Congenital lordosis can be associated with other congenital malformations, particularly those affecting the spine and pelvis. It may result from developmental anomalies during embryogenesis, such as vertebral segmentation defects or abnormal formation of the vertebrae. Clinically, children with congenital lordosis may present with a noticeable curvature of the spine, which can lead to discomfort, pain, or functional limitations as they grow. Early diagnosis and intervention are crucial to manage the condition effectively, which may include physical therapy, bracing, or surgical options in severe cases. The condition can also be associated with other musculoskeletal deformities, such as scoliosis or hip dysplasia, necessitating a comprehensive evaluation of the child's musculoskeletal system.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between congenital and acquired lordosis
  • Identifying associated congenital malformations
  • Variability in clinical presentation and severity
  • Need for multidisciplinary evaluation and management

Audit Risk Factors

  • Inadequate documentation of the congenital nature of the condition
  • Failure to document associated congenital anomalies
  • Misclassification of lordosis as acquired
  • Lack of clarity in the clinical rationale for the diagnosis

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed growth and development assessments, physical examination findings, and any interventions or referrals made.

Common Clinical Scenarios

A pediatric patient presenting with back pain and a noticeable spinal curvature, requiring evaluation for congenital lordosis.

Billing Considerations

Consideration of the child's age, developmental milestones, and any associated musculoskeletal conditions.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

A child with congenital lordosis being evaluated for potential genetic syndromes that may include musculoskeletal anomalies.

Billing Considerations

Understanding the genetic basis of congenital malformations and the implications for family counseling.

Coding Guidelines

Inclusion Criteria

Use Q76.425 When
  • Follow ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of the congenital nature and any associated anomalies
  • Use additional codes for related conditions as necessary

Exclusion Criteria

Do NOT use Q76.425 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used in conjunction with physical therapy for management of lordosis.

Documentation Requirements

Documentation of the patient's progress and response to therapy.

Specialty Considerations

Pediatric physical therapy notes should detail the specific exercises and goals.

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.

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.

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 significance of coding congenital lordosis accurately?

Accurate coding of congenital lordosis is crucial for appropriate treatment planning, reimbursement, and understanding the prevalence of congenital conditions. It also aids in identifying associated anomalies that may require additional management.