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ICD-10 Guide
ICD-10 CodesM21.06

M21.06

Billable

Valgus deformity, not elsewhere classified, knee

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

Code Description

ICD-10 M21.06 is a billable code used to indicate a diagnosis of valgus deformity, not elsewhere classified, knee.

Key Diagnostic Point:

Valgus deformity of the knee refers to a condition where the knee joint is angled outward, resulting in a misalignment that can lead to various complications, including pain, instability, and increased wear on the joint. This deformity can be acquired due to factors such as obesity, arthritis, or previous injuries that alter the normal biomechanics of the knee. Patients may present with symptoms such as knee pain, difficulty walking, and a noticeable outward angling of the knee. The condition can also lead to secondary issues, including osteoarthritis due to uneven weight distribution across the joint surfaces. Treatment options may include physical therapy, bracing, or surgical interventions such as osteotomy or arthroplasty, depending on the severity of the deformity and the patient's overall health. Accurate coding is essential for proper management and reimbursement, as it reflects the complexity of the condition and the necessity for potential corrective procedures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the deformity
  • Differentiation from other knee deformities (e.g., varus deformity)
  • Potential for co-existing conditions (e.g., arthritis)
  • Need for detailed documentation of the deformity's impact on function

Audit Risk Factors

  • Inadequate documentation of the deformity's impact on function
  • Failure to specify whether the deformity is acquired or congenital
  • Lack of supporting evidence for surgical interventions
  • Misclassification of the deformity type

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes describing the deformity, treatment plan, and any imaging studies.

Common Clinical Scenarios

Patients presenting with knee pain and deformity, post-operative follow-ups after corrective surgery.

Billing Considerations

Ensure to document the degree of deformity and any functional limitations experienced by the patient.

Physical Therapy

Documentation Requirements

Progress notes detailing the patient's functional status and response to therapy.

Common Clinical Scenarios

Rehabilitation following surgical correction of valgus deformity.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M21.06 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's nature (acquired vs
  • congenital) and any associated conditions
  • Include details on the severity and functional impact of the deformity

Exclusion Criteria

Do NOT use M21.06 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Osteotomy, knee

Clinical Scenario

Used for surgical correction of valgus deformity.

Documentation Requirements

Pre-operative assessment, surgical notes, and post-operative follow-up documentation.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of knee deformities, improving the accuracy of diagnoses and treatment plans. M21.06 provides a clear classification for acquired valgus deformity, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of knee deformities, improving the accuracy of diagnoses and treatment plans. M21.06 provides a clear classification for acquired valgus deformity, facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of knee deformities, improving the accuracy of diagnoses and treatment plans. M21.06 provides a clear classification for acquired valgus deformity, facilitating better patient management.

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 M21.06 and M21.05?

M21.06 refers specifically to acquired valgus deformity of the knee, while M21.05 refers to varus deformity, which is an inward angling of the knee.