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ICD-10 Guide
ICD-10 CodesM21.05

M21.05

Billable

Valgus deformity, not elsewhere classified, hip

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M21.05 is a billable code used to indicate a diagnosis of valgus deformity, not elsewhere classified, hip.

Key Diagnostic Point:

Valgus deformity of the hip is characterized by an abnormal angulation of the femur at the hip joint, resulting in a lateral deviation of the limb. This condition can be acquired due to various factors such as trauma, degenerative diseases, or post-surgical changes. Acquired valgus deformities may arise from conditions like osteoarthritis, rheumatoid arthritis, or following hip fractures that lead to malalignment. The deformity can lead to functional limitations, pain, and an altered gait pattern. In some cases, it may also contribute to secondary complications such as joint instability or increased wear on the hip joint. Treatment options often include physical therapy, orthotic devices, and in severe cases, surgical interventions such as osteotomy or arthroplasty to correct the alignment and restore function. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between congenital and acquired deformities
  • Understanding the specific anatomical location and type of valgus deformity
  • Identifying associated conditions that may complicate the diagnosis
  • Navigating documentation requirements for surgical interventions

Audit Risk Factors

  • Inadequate documentation of the deformity's cause
  • Failure to document associated conditions
  • Misclassification of the deformity type
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes on the deformity's etiology, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with hip pain and gait abnormalities, post-operative evaluations following hip surgeries.

Billing Considerations

Ensure that all imaging studies and consultations are documented to support the diagnosis.

Physical Therapy

Documentation Requirements

Progress notes detailing functional assessments, treatment interventions, and patient responses.

Common Clinical Scenarios

Rehabilitation following corrective surgery for hip valgus deformity.

Billing Considerations

Document specific therapeutic exercises and their impact on the patient's mobility.

Coding Guidelines

Inclusion Criteria

Use M21.05 When
  • Follow the official ICD
  • CM guidelines for coding and reporting, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant modifiers for surgical procedures and co
  • existing conditions

Exclusion Criteria

Do NOT use M21.05 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe valgus deformity requiring joint replacement.

Documentation Requirements

Pre-operative assessments, imaging studies, and surgical notes.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and expected outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformity, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformity, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like valgus deformity, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

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 primary cause of valgus deformity in the hip?

Valgus deformity in the hip can be caused by various factors, including trauma, degenerative joint diseases, and post-surgical changes. It is essential to identify the underlying cause for appropriate management.