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ICD-10 Guide
ICD-10 CodesM21.169

M21.169

Billable

Varus deformity, not elsewhere classified, unspecified knee

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

Code Description

ICD-10 M21.169 is a billable code used to indicate a diagnosis of varus deformity, not elsewhere classified, unspecified knee.

Key Diagnostic Point:

Varus deformity of the knee, often referred to as bowleggedness, is characterized by an inward angulation of the knee joint, resulting in a noticeable gap between the knees when the individual stands with their feet together. This condition can be acquired due to various factors, including obesity, osteoarthritis, or previous injuries that alter the alignment of the knee. The deformity can lead to uneven weight distribution across the knee joint, potentially causing pain, instability, and increased wear on the cartilage. In children, varus deformity may be a normal part of development, but if persistent, it may require intervention. In adults, it is often associated with degenerative changes and may necessitate corrective procedures such as osteotomy or arthroplasty to restore proper alignment and function. Accurate diagnosis and coding are essential for appropriate management and reimbursement, as the condition can significantly impact mobility and quality of life.

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 valgus deformity.
  • Need for comprehensive documentation of the underlying cause.
  • Potential for co-morbid conditions affecting the knee.

Audit Risk Factors

  • Inadequate documentation of the deformity's severity.
  • Failure to specify laterality when applicable.
  • Lack of evidence for conservative management before surgical intervention.
  • Inconsistent coding of associated conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including physical examination findings, imaging results, and treatment history.

Common Clinical Scenarios

Patients presenting with knee pain, difficulty walking, or deformity noted during routine examination.

Billing Considerations

Ensure to document any prior treatments or interventions that may have influenced the current condition.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment plans, and progress notes detailing rehabilitation efforts.

Common Clinical Scenarios

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

Billing Considerations

Document the impact of the deformity on daily activities and quality of life.

Coding Guidelines

Inclusion Criteria

Use M21.169 When
  • Follow the ICD
  • CM coding guidelines for accurate reporting of conditions
  • Ensure to document the clinical rationale for the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use M21.169 When
  • Exclude conditions that are specifically classified elsewhere

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Osteotomy, knee

Clinical Scenario

Used for correction of varus deformity in adults.

Documentation Requirements

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

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 patient records and facilitating better treatment planning.

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 patient records and facilitating better treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like varus deformity, improving the accuracy of patient records and facilitating better treatment planning.

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 varus and valgus deformity?

Varus deformity refers to inward angulation of the knee, while valgus deformity refers to outward angulation. Accurate coding requires understanding these distinctions.