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ICD-10 Guide
ICD-10 CodesQ72.00

Q72.00

Billable

Congenital complete absence of unspecified lower limb

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q72.00 is a billable code used to indicate a diagnosis of congenital complete absence of unspecified lower limb.

Key Diagnostic Point:

Congenital complete absence of an unspecified lower limb refers to a condition where a child is born without one of their lower limbs. This condition can occur due to various factors, including genetic mutations, environmental influences during pregnancy, or disruptions in limb development. The absence can be unilateral or bilateral, but in this case, it is unspecified. The condition may be associated with other congenital malformations or syndromes, such as limb reduction defects, which can affect the musculoskeletal system. Children with this condition may require multidisciplinary care, including orthopedic interventions, prosthetic fitting, and physical therapy to enhance mobility and function. Early diagnosis and intervention are crucial for optimizing developmental outcomes and addressing any associated complications. The absence of a limb can significantly impact a child's physical and psychosocial development, necessitating a comprehensive approach to care that includes family support and counseling.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of limb absence (unilateral vs bilateral)
  • Potential association with other congenital anomalies
  • Need for precise anatomical terminology in coding
  • Differentiation from acquired limb loss

Audit Risk Factors

  • Inadequate documentation of limb absence specifics
  • Failure to document associated congenital conditions
  • Misclassification of congenital vs acquired conditions
  • Lack of clarity in clinical notes regarding limb development

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes describing the limb absence, associated conditions, and treatment plans are essential. Documentation should include physical examination findings and any imaging studies.

Common Clinical Scenarios

Common scenarios include newborn assessments revealing limb absence, referrals for orthopedic evaluation, and discussions regarding prosthetic options.

Billing Considerations

Consideration of developmental milestones and psychosocial support for the child and family is crucial in pediatric care.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations should be documented. Genetic counseling notes are also important.

Common Clinical Scenarios

Scenarios may include genetic evaluations for syndromes associated with limb absence and discussions about recurrence risks in future pregnancies.

Billing Considerations

Understanding the genetic basis of congenital limb absence can guide management and counseling.

Coding Guidelines

Inclusion Criteria

Use Q72.00 When
  • 10 guidelines specify that congenital conditions should be coded based on the specific anatomical site and nature of the malformation
  • Documentation must support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use Q72.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27599CPT Code

Unlisted procedure, lower extremity

Clinical Scenario

Used when performing a unique surgical procedure related to limb absence.

Documentation Requirements

Detailed operative notes and justification for the unlisted procedure.

Specialty Considerations

Orthopedic specialists should provide comprehensive documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, 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 congenital conditions, 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 documentation is needed to support the diagnosis of congenital complete absence of a lower limb?

Documentation should include a detailed physical examination, imaging studies if performed, and any associated congenital anomalies. It is also important to document the impact on the child's development and any planned interventions.