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ICD-10 Guide
ICD-10 CodesM21.12

M21.12

Billable

Varus deformity, not elsewhere classified, elbow

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

Code Description

ICD-10 M21.12 is a billable code used to indicate a diagnosis of varus deformity, not elsewhere classified, elbow.

Key Diagnostic Point:

Varus deformity of the elbow is characterized by an inward angulation of the forearm relative to the humerus, resulting in a 'bowing' appearance. This condition can be acquired due to various factors, including trauma, arthritis, or developmental issues. Patients may experience pain, limited range of motion, and functional impairment, particularly in activities requiring elbow flexion and extension. The deformity can lead to secondary complications such as joint instability and increased wear on the articular surfaces. Diagnosis typically involves a thorough clinical examination, imaging studies such as X-rays, and assessment of the patient's functional capabilities. Treatment options may include physical therapy, bracing, or surgical intervention to correct the alignment and restore function. Understanding the underlying cause of the varus deformity is crucial for determining the appropriate management strategy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between congenital and acquired deformities
  • Need for precise documentation of the deformity's severity
  • Potential for co-existing conditions affecting the elbow
  • Variability in treatment approaches based on the underlying cause

Audit Risk Factors

  • Inadequate documentation of the deformity's characteristics
  • Failure to specify the acquired nature of the deformity
  • Lack of imaging studies to support the diagnosis
  • Incorrect linkage of the diagnosis to treatment procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed clinical notes on the deformity's assessment, imaging results, and treatment plan.

Common Clinical Scenarios

Patients presenting with elbow pain and deformity after trauma or chronic conditions.

Billing Considerations

Ensure that the documentation reflects the acquired nature of the deformity and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes related to rehabilitation.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those with chronic pain due to varus deformity.

Billing Considerations

Document the impact of the deformity on the patient's daily activities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use M21.12 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the deformity's nature and any associated conditions
  • Include details on the acquired nature of the deformity and any relevant imaging findings

Exclusion Criteria

Do NOT use M21.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

24357CPT Code

Osteotomy, elbow

Clinical Scenario

Used for correction of varus deformity in surgical cases.

Documentation Requirements

Surgical notes detailing the procedure and indications.

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 varus deformity, 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 conditions like varus deformity, 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 primary cause of varus deformity in adults?

In adults, varus deformity is often acquired due to conditions such as osteoarthritis, rheumatoid arthritis, or following trauma. It can also develop as a result of repetitive stress on the elbow joint.