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ICD-10 Guide
ICD-10 CodesM21.95

M21.95

Billable

Unspecified acquired deformity of thigh

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

Code Description

ICD-10 M21.95 is a billable code used to indicate a diagnosis of unspecified acquired deformity of thigh.

Key Diagnostic Point:

M21.95 refers to an unspecified acquired deformity of the thigh, which can arise from various causes such as trauma, surgery, or underlying medical conditions. Acquired deformities may manifest as changes in the shape or structure of the thigh, potentially affecting mobility and function. These deformities can result from conditions like osteoarthritis, fractures that heal improperly, or muscle imbalances. The thigh's anatomy includes the femur, muscles, and connective tissues, and any alteration can lead to significant functional impairment. Patients may present with symptoms such as pain, reduced range of motion, or difficulty in weight-bearing activities. Treatment options often involve physical therapy, orthotic devices, or surgical interventions aimed at correcting the deformity and restoring function. Accurate coding is essential for appropriate management and reimbursement, as it reflects the complexity of the patient's condition and the care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of acquired deformities
  • Differentiation from congenital deformities
  • Need for detailed clinical history to establish causation
  • Potential overlap with other musculoskeletal codes

Audit Risk Factors

  • Insufficient documentation of the acquired nature of the deformity
  • Lack of detailed clinical notes regarding treatment and outcomes
  • Inconsistent coding practices among providers
  • Failure to link the deformity to a specific incident or condition

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including history of the deformity, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with post-traumatic deformities, post-surgical complications, or degenerative changes.

Billing Considerations

Ensure that the documentation clearly states the acquired nature of the deformity and any related functional impairments.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments including functional limitations and rehabilitation goals.

Common Clinical Scenarios

Patients requiring rehabilitation after surgery or injury leading to thigh deformities.

Billing Considerations

Focus on the impact of the deformity on daily activities and the rehabilitation process.

Coding Guidelines

Inclusion Criteria

Use M21.95 When
  • According to ICD
  • 10 coding guidelines, M21
  • 95 should be used when the specific cause of the acquired deformity is not documented
  • Coders should ensure that the documentation supports the use of this code and consider more specific codes if available

Exclusion Criteria

Do NOT use M21.95 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Osteotomy, femur

Clinical Scenario

Used in cases where surgical correction of the thigh deformity is necessary.

Documentation Requirements

Operative reports detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons should provide clear documentation of the deformity and rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, enabling better tracking of treatment outcomes and resource allocation. M21.95 reflects the need for detailed documentation to support the complexity of the condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, enabling better tracking of treatment outcomes and resource allocation. M21.95 reflects the need for detailed documentation to support the complexity of the condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding acquired deformities, enabling better tracking of treatment outcomes and resource allocation. M21.95 reflects the need for detailed documentation to support the complexity of the condition.

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 documentation is required to support the use of M21.95?

Documentation should include a detailed clinical history, physical examination findings, and any imaging studies that support the diagnosis of an acquired deformity of the thigh.