ICD-10 Coding for Hallux Valgus(M20.11, Q66.212)
Complete ICD-10-CM coding and documentation guide for Hallux Valgus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hallux Valgus
M20.10-M20.12Primary Range
Acquired hallux valgus
This range covers acquired deformities of the big toe, commonly known as bunions.
Congenital metatarsus primus varus
This range is used for congenital deformities of the foot, specifically affecting the metatarsus.
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 | Acquired hallux valgus, right foot | Use when there is a documented structural deformity of the right foot with hallux valgus. |
|
| Q66.212 | Congenital metatarsus primus varus, left foot | Use for congenital deformities noted since birth. |
|
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
Essential facts and insights about Hallux Valgus
Primary ICD-10-CM Codes for hallux valgus
Decision Criteria
clinical Criteria
- Presence of pain and structural deformity
documentation Criteria
- Explicit mention of right foot and hallux valgus
Applicable To
- Bunion of right foot
Excludes
- Congenital hallux valgus (Q66.21x)
Clinical Validation Requirements
- HVA >15° on weight-bearing radiograph
- Documented structural deformity
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented clearly to avoid denials.
Q66.212 - Congenital metatarsus primus varus, left foot
Use for congenital deformities noted since birth.
Applicable To
- Congenital deformity of left foot
Excludes
- Acquired hallux valgus (M20.1x)
Clinical Validation Requirements
- Pediatric orthopedic evaluation
- Imaging confirmation
Coding Notes
Ensure congenital nature is documented to avoid misclassification.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute post-procedural pain
G89.18Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hallux Valgus 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: Potential for audit issues, Financial: Claims denial due to unspecified coding
Mitigation Strategy
Standardize documentation templates to include laterality, Educate staff on importance of complete documentation
Impact
Reimbursement: Denial due to incorrect coding, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Switch to M20.1x if structural deformity/pain present
Impact
Using incorrect CPT codes for bunionectomy can lead to audits.
Mitigation Strategy
Verify procedure details and match with appropriate CPT codes.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hallux Valgus
Use these documentation templates to ensure complete and accurate documentation for Hallux Valgus. These templates include all required elements for proper coding and billing.
Post-operative follow-up for hallux valgus correction
Specialty: OrthopedicsRequired Elements
- Patient-reported outcomes
- Incision status
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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