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v1.0.0
ICD-10 Guide
ICD-10 CodesQ87.2

Q87.2

Billable

Congenital malformation syndromes predominantly involving limbs

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

Code Description

ICD-10 Q87.2 is a billable code used to indicate a diagnosis of congenital malformation syndromes predominantly involving limbs.

Key Diagnostic Point:

Congenital malformation syndromes predominantly involving limbs encompass a variety of genetic and environmental factors leading to structural anomalies primarily affecting the limbs. These syndromes can manifest as limb reduction defects, polydactyly, syndactyly, and other deformities that may also involve associated anomalies in other organ systems. Conditions such as Holt-Oram syndrome, which affects the heart and upper limbs, and Poland syndrome, characterized by unilateral absence of the pectoralis major muscle and associated limb anomalies, are examples of syndromes that may fall under this code. The clinical presentation can vary widely, and a thorough evaluation is essential to identify any associated congenital malformations, including those affecting the skin, breast, spleen, and adrenal glands. Accurate coding requires comprehensive documentation of the limb anomalies and any additional congenital conditions present, as these can significantly impact treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and associated anomalies
  • Need for detailed documentation of limb and associated malformations
  • Potential overlap with other congenital codes
  • Requirement for genetic testing results in some cases

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Misclassification of syndromic versus non-syndromic conditions
  • Failure to include genetic testing results when applicable
  • Inconsistent use of codes for similar conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include detailed descriptions of limb anomalies, associated conditions, and developmental assessments.

Common Clinical Scenarios

Common scenarios include evaluations for limb reduction defects, syndactyly, and polydactyly in newborns and children.

Billing Considerations

Consideration of growth and developmental milestones is crucial for accurate coding and management.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Genetic counseling for families with a history of congenital limb malformations and syndromic conditions.

Billing Considerations

Understanding the genetic basis of limb malformations is essential for accurate coding and patient management.

Coding Guidelines

Inclusion Criteria

Use Q87.2 When
  • Official coding guidelines for congenital and chromosomal conditions emphasize the importance of specificity in documentation, including the need to report associated congenital anomalies and syndromic features when applicable

Exclusion Criteria

Do NOT use Q87.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit

Clinical Scenario

Used for follow-up visits in patients with congenital limb anomalies.

Documentation Requirements

Documentation must include a review of systems and assessment of limb anomalies.

Specialty Considerations

Pediatric specialists should ensure comprehensive evaluations are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, 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 malformations, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Congenital Malformations

Coding & Billing References

  • •
    CDC Congenital Malformations

Frequently Asked Questions

What documentation is required for coding Q87.2?

Documentation must include detailed descriptions of limb anomalies, any associated congenital conditions, and results from genetic testing if applicable. Clear clinical notes are essential for accurate coding.