ICD-10 Coding for Hallux Limitus(M20.11, M20.12, M20.10)
Complete ICD-10-CM coding and documentation guide for Hallux Limitus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hallux Limitus
M20.1-M20.12Primary Range
Hallux limitus, unspecified foot, right foot, left foot
This range covers hallux limitus, distinguishing it from hallux rigidus, which is more severe.
Hallux rigidus, unspecified foot, right foot, left foot
This range is for hallux rigidus, the end-stage of hallux limitus.
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 limitus, right foot | Use when hallux limitus is diagnosed in the right foot with specified clinical findings. |
|
| M20.12 | Hallux limitus, left foot | Use when hallux limitus is diagnosed in the left foot with specified clinical findings. |
|
| M20.10 | Hallux limitus, unspecified foot | Use when hallux limitus is diagnosed but laterality is not specified. |
|
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 hallux limitus
Essential facts and insights about Hallux Limitus
Primary ICD-10-CM Codes for hallux limitus
Decision Criteria
clinical Criteria
- Dorsiflexion between 25° and 30° with pain on activity
documentation Criteria
- Specify laterality and degree of motion
Applicable To
- Functional hallux limitus
- Structural hallux limitus
Excludes
- Hallux rigidus (M20.21)
Clinical Validation Requirements
- Reduced dorsiflexion (25°–30°)
- Pain on activity
- No crepitus
Code-Specific Risks
- Misclassification as hallux rigidus
Coding Notes
- Ensure documentation specifies laterality and degree of dorsiflexion.
M20.12 - Hallux limitus, left foot
Use when hallux limitus is diagnosed in the left foot with specified clinical findings.
Applicable To
- Functional hallux limitus
- Structural hallux limitus
Excludes
- Hallux rigidus (M20.22)
Clinical Validation Requirements
- Reduced dorsiflexion (25°–30°)
- Pain on activity
- No crepitus
Coding Notes
Ensure documentation specifies laterality and degree of dorsiflexion.
M20.10 - Hallux limitus, unspecified foot
Use when hallux limitus is diagnosed but laterality is not specified.
Applicable To
- Functional hallux limitus
- Structural hallux limitus
Excludes
- Hallux rigidus (M20.20)
Clinical Validation Requirements
- Reduced dorsiflexion (25°–30°)
- Pain on activity
- No crepitus
Coding Notes
Avoid using this code unless laterality cannot be determined.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Hallux Limitus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M20.11.
Impact
Clinical: Leads to incomplete clinical assessment., Regulatory: Non-compliance with documentation standards., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Ensure imaging results are included in the patient's record, Use checklists to verify documentation completeness
Impact
Reimbursement: Incorrect coding may lead to improper reimbursement levels., Compliance: Misclassification can result in compliance issues during audits., Data Quality: Impacts the accuracy of clinical data and patient records.
Mitigation Strategy
Verify the degree of dorsiflexion and presence of crepitus before coding.
Impact
Reimbursement: Lack of specificity can affect claim processing., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces the quality and specificity of patient data.
Mitigation Strategy
Ensure documentation specifies right or left foot.
Impact
Failure to specify laterality can lead to audit findings.
Mitigation Strategy
Implement documentation templates that require laterality.
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 Hallux Limitus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hallux Limitus
Use these documentation templates to ensure complete and accurate documentation for Hallux Limitus. These templates include all required elements for proper coding and billing.
Diagnosis of hallux limitus with orthotic management
Specialty: PodiatryRequired Elements
- Subjective: Patient's description of symptoms
- Objective: Physical exam findings
- Assessment: Diagnosis with ICD-10 code
- Plan: Treatment plan including orthotics
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hallux Limitus? Ask your questions below.