ICD-10 Coding for Bunion(M20.11, M21.611)
Complete ICD-10-CM coding and documentation guide for Bunion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bunion
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M20.11 | Hallux valgus (acquired), right foot | Use when there is a structural deformity with lateral deviation of the hallux on the right foot. |
|
| M21.611 | Bunion, right foot | Use when there is a bony prominence without valgus deviation on the right foot. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bunion
Essential facts and insights about Bunion
Primary ICD-10-CM Codes for bunion
Decision Criteria
clinical Criteria
- Presence of lateral deviation and structural deformity.
Applicable To
- Structural deformity with lateral deviation of the hallux
Excludes
- Congenital hallux valgus (Q66.8)
Clinical Validation Requirements
- HVA ≥20°
- IMA ≥14°
Code-Specific Risks
- Incorrectly coding as M21.611 if there is a structural deformity.
Coding Notes
- Ensure documentation specifies lateral deviation and structural deformity.
M21.611 - Bunion, right foot
Use when there is a bony prominence without valgus deviation on the right foot.
Applicable To
- Cosmetic prominence without valgus deviation
Excludes
- Hallux valgus (M20.11)
Clinical Validation Requirements
- Radiographic IMA <9°
- No sesamoid displacement
Coding Notes
Ensure documentation specifies absence of valgus deviation.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bunion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M20.11.
Impact
Clinical: Ambiguity in treatment records., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document laterality in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify structural deformity and lateral deviation for hallux valgus.
Impact
Using M21.611 for cases with structural deformity.
Mitigation Strategy
Implement regular training on code differentiation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bunion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bunion
Use these documentation templates to ensure complete and accurate documentation for Bunion. These templates include all required elements for proper coding and billing.
Operative Note for Bunionectomy
Specialty: Orthopedic SurgeryRequired Elements
- Incision type and location
- Osteotomy details
- Fixation method
- Pre/post-op measurements
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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