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ICD-10 Coding for Hallux Valgus Deformity(M20.11, M20.12)

Complete ICD-10-CM coding and documentation guide for Hallux Valgus Deformity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

BunionHallux Abducto Valgus

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Related ICD-10 Code Ranges

Complete code families applicable to Hallux Valgus Deformity

M20.1Primary Range

Acquired hallux valgus

This range covers acquired deformities of the hallux, commonly known as bunions.

Q66.21

Congenital metatarsus primus varus

This range is used for congenital deformities of the first metatarsal.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M20.11Hallux valgus (acquired), right footUse when there is a confirmed structural deformity of the right hallux with documented symptoms.
  • Radiographic evidence of hallux valgus angle ≥15°
  • Failed conservative treatment documented
M20.12Hallux valgus (acquired), left footUse when there is a confirmed structural deformity of the left hallux with documented symptoms.
  • Radiographic evidence of hallux valgus angle ≥15°
  • Failed conservative treatment documented

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 valgus deformity

Essential facts and insights about Hallux Valgus Deformity

The ICD-10 code for hallux valgus deformity is M20.11 for the right foot and M20.12 for the left foot.

Primary ICD-10-CM Codes for hallux valgus deformity

M20.11
Hallux valgus (acquired), right foot
Billable Code

Decision Criteria

clinical Criteria

  • Presence of hallux valgus angle ≥15°

documentation Criteria

  • Documented failure of conservative treatments

Applicable To

  • Bunion of right foot

Excludes

  • Congenital hallux valgus (Q66.21)

Clinical Validation Requirements

  • Radiographic evidence of hallux valgus angle ≥15°
  • Failed conservative treatment documented

Code-Specific Risks

  • Incorrect use without radiographic confirmation

Coding Notes

  • Ensure documentation includes specific angles and failed treatments.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Gait abnormality

R26.89
Use to document associated gait disturbances.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Bunion, right foot

M21.611
Use when there is a bony prominence without metatarsal deviation.

Bunion, left foot

M21.612
Use when there is a bony prominence without metatarsal deviation.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Hallux Valgus Deformity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M20.11.

Impact

Clinical: Misdiagnosis or inappropriate treatment planning., Regulatory: Potential for audit failure., Financial: Claim denials due to insufficient documentation.

Mitigation Strategy

Ensure all radiographic findings are documented in detail., Regularly update documentation practices.

Impact

Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Ensure documentation specifies if a medial eminence resection was performed.

Impact

High risk of audit if surgical procedures are not documented with specific techniques.

Mitigation Strategy

Ensure detailed operative notes and radiographic evidence are included in patient records.

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 Valgus Deformity, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Hallux Valgus Deformity

Use these documentation templates to ensure complete and accurate documentation for Hallux Valgus Deformity. These templates include all required elements for proper coding and billing.

Podiatry Progress Note for Surgical Candidate

Specialty: Podiatry

Required Elements

  • Subjective history of deformity
  • Objective findings with radiographic angles
  • Assessment of hallux valgus
  • Plan for surgical intervention

Example Documentation

55F with progressive right foot deformity x3 years. Failed 8 months of: Custom orthotics, 2 corticosteroid injections, Wide toe box shoe trial. Current pain: 7/10 VAS limiting ambulation >15 minutes.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient complains of foot pain.
Good Documentation Example
15° hallux valgus angle with medial eminence hypertrophy causing shoe-fitting difficulty unresponsive to 6 months of orthotics and corticosteroid injections.
Explanation
The good example provides specific clinical findings and treatment history, supporting medical necessity.

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