Primary Care Coding Alert

Question: What diagnosis should we report for "intoeing"?

New Hampshire Subscriber

Answer: The best diagnosis could depend partly on the patient's age. ICD-9 lists 735.8 (Other acquired deformities of toe) for pigeon toes. If you're coding for a young child, however, and the condition is not acquired, many coders select 754.53 (Certain congenital musculoskeletal deformities; varus deformities of feet; metatarsus varus). Discuss the case with your physician to determine which diagnosis is more accurate.

Terminology: Code 754.60 (Congenital talipes valgus) seems like a possible diagnosis for this case, considering the accompanying notes states, "Congenital valgus deformity of foot, unspecified." However, the term "valgus" means bent outward and "varus" means bent inward. Because the patient was diagnosed with "intoeing," the varus code seems more appropriate than the valgus code.