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ICD-10 Guide
ICD-10 CodesM21.069

M21.069

Billable

Valgus deformity, not elsewhere classified, unspecified knee

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

Code Description

ICD-10 M21.069 is a billable code used to indicate a diagnosis of valgus deformity, not elsewhere classified, unspecified knee.

Key Diagnostic Point:

Valgus deformity of the knee is characterized by an abnormal angulation of the knee joint, where the distal segment of the limb is angled away from the midline of the body. This condition can be acquired due to various factors such as trauma, degenerative joint disease, or inflammatory conditions. It may lead to functional impairment, pain, and increased risk of osteoarthritis due to abnormal stress on the joint. Valgus deformities can also be associated with other conditions such as hallux valgus, which affects the big toe, and can result in secondary deformities of the foot and ankle. Corrective procedures may include osteotomy, arthroplasty, or the use of braces to realign the knee joint. Accurate coding is essential for proper treatment planning and reimbursement, as well as for tracking the prevalence and outcomes of this condition in clinical practice.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the deformity.
  • Differentiation from other knee deformities such as varus deformity.
  • Need for comprehensive documentation to support the diagnosis.
  • Potential for co-existing conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the deformity's severity.
  • Failure to specify laterality when applicable.
  • Lack of supporting clinical evidence for the diagnosis.
  • Incorrect linkage of the diagnosis to treatment procedures.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with knee pain, instability, or functional limitations due to valgus deformity.

Billing Considerations

Documentation should clearly outline the impact of the deformity on the patient's mobility and quality of life.

Physical Therapy

Documentation Requirements

Therapy notes detailing the patient's functional status, treatment goals, and progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-corrective surgery for valgus deformity.

Billing Considerations

Therapists should document the specific exercises and modalities used to address the deformity.

Coding Guidelines

Inclusion Criteria

Use M21.069 When
  • According to ICD
  • 10 guidelines, M21
  • 069 should be used when the valgus deformity is not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and that it meets the criteria for specificity and accuracy

Exclusion Criteria

Do NOT use M21.069 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Osteotomy, knee

Clinical Scenario

Used for realignment of the knee joint in cases of severe 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 conditions like valgus deformity, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of treatment 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 data collection and reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of treatment 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 difference between M21.069 and M21.061?

M21.069 is used for unspecified knee valgus deformity, while M21.061 specifies a valgus deformity of the right knee. Accurate coding requires identifying the laterality when applicable.