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v1.0.0
ICD-10 Guide
ICD-10 CodesQ72.90

Q72.90

Billable

Unspecified reduction defect of unspecified lower limb

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

Code Description

ICD-10 Q72.90 is a billable code used to indicate a diagnosis of unspecified reduction defect of unspecified lower limb.

Key Diagnostic Point:

Unspecified reduction defect of the lower limb refers to a congenital malformation characterized by the incomplete formation or absence of one or more parts of the lower limb. This condition can manifest as limb reduction, where the limb is shorter than normal or has missing segments, which may include the absence of toes, feet, or even the entire leg. The etiology of these defects can be multifactorial, including genetic predispositions, environmental factors, or teratogenic influences during pregnancy. Clinically, these defects can lead to significant functional impairment, affecting mobility and overall quality of life. Management often involves a multidisciplinary approach, including orthopedic interventions, physical therapy, and possibly surgical correction to improve limb function and appearance. Early diagnosis and intervention are crucial for optimizing outcomes in affected children.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of limb reduction defects.
  • Need for detailed clinical documentation to support the diagnosis.
  • Potential overlap with other congenital conditions, complicating coding.
  • Variations in treatment protocols and follow-up care across specialties.

Audit Risk Factors

  • Inadequate documentation of the specific nature of the limb defect.
  • Failure to include relevant clinical history or genetic testing results.
  • Misclassification of the defect type leading to incorrect coding.
  • Lack of follow-up documentation on treatment outcomes.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation should include detailed descriptions of the limb defect, associated anomalies, and any interventions performed.

Common Clinical Scenarios

Common scenarios include newborn assessments revealing limb reduction defects, referrals for orthopedic evaluation, and follow-up visits for growth and development.

Billing Considerations

Considerations include the need for ongoing assessments of limb function and potential psychosocial impacts on the child and family.

Genetics

Documentation Requirements

Genetic documentation should include family history, results of genetic testing, and any syndromic associations.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital limb defects and discussions about recurrence risks.

Billing Considerations

Considerations include the need for comprehensive genetic evaluations to identify potential syndromes associated with limb reduction defects.

Coding Guidelines

Inclusion Criteria

Use Q72.90 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring specificity in documentation and adherence to coding conventions for congenital conditions

Exclusion Criteria

Do NOT use Q72.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27500CPT Code

Amputation, leg, below knee

Clinical Scenario

Used in cases where limb reduction defects necessitate surgical intervention.

Documentation Requirements

Detailed operative notes and pre-operative assessments.

Specialty Considerations

Orthopedic specialists should provide comprehensive documentation to support the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track outcomes and resource utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track outcomes and resource utilization.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, improving data accuracy and enhancing the ability to track outcomes and resource utilization.

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 for coding Q72.90?

Documentation should include a detailed description of the limb defect, any associated anomalies, and the clinical rationale for the diagnosis. Genetic testing results and family history may also be relevant.