ICD 10 Coding Alert

Question: A patient returns to my podiatry practice’s office, complaining of continuing bunion pain. The patient has tried conservative care, including wearing wider shoes. From an X-ray, our podiatrist observes that the patient has a hypertrophied medial aspect with increased intermetatarsal angle and a deviated first toe. She removes the hypertrophied section of the bone. She also performs distal metatarsal osteotomy of the first metatarsal to realign the bone. Which ICD-10 code would be the best choice?

New Mexico Subscriber

Answer: You should report M20.12 (Hallux valgus (acquired), left foot) and M21.612 (Bunion of left foot).

Although many people may think bunions and hallux valgus are the same condition, there are actually differences between the two, says Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan.

“A bunion is just the increased bone on the medial side of the first metatarsal,” Beresh explains. “Hallux valgus is when the tip of the first toe turns toward the second toe and usually applies pressure on the head of the first metatarsal, causing the deformity.”

If both conditions occur, it should technically be referred to as hallux valgus with a bunion deformity, Beresh says. Some insurance companies will not pay for surgical corrections of hallux valgus (28296) with only the definition and code for bunion, and not the coding for the hallux valgus.