08/29/2018
Correct Coding for Bunions/Hallux Valgus
I attended a billing seminar and was told that the correct ICD 10 coding for bunions/hallux valgus was changing from M20.11/M20.12 to M21.611/M21.612. My billing service is telling me that the first code is for hallux valgus and the second is for bunion. They advised me to use the first code for bunion surgeries. Is this true?
Below are the definitions for the four ICD codes cited:
- M20.21 (Hallux valgus (acquired), right foot) [excluding bunion M21.6_]
- M20.22 (Hallux valgus (acquired), left foot) [excluding bunion M21.6_]
- M21.611 (Bunion of right foot) [excluding deformities of toe (acquired) (M20.1-M20.6_)
- M21.612 (Bunion of left foot) [excluding deformities of toe (acquired) (M20.1-M20.6_)
Your billing company would be correct with using a hallux valgus ICD code over the bunion code. M20.2X specifies that there is a structural problem that has progressed over time that needs to be corrected with surgery from a podiatrist. A bunion ICD code (M21.61X) indicates that while there is the characteristic bump, a patient may not have any pain, musculoskeletal deformities, or any other symptoms associated with hallux valgus, which is a more complex condition that has evolved from a simple bunion, which could be asymptomatic aside from the cosmetic appearance on the patient’s foot.
The codes have not changed, but it is important to be specific in selecting the appropriate codes. It is suggested, you always use the ICD-10 Book with exact description. As there are also codes for a bunionette etc..