Radiology Coding Alert

Question: I have encounter notes that indicate the radiologist diagnosed the patient with contracture of the right foot after taking X-rays. What diagnosis code(s) do I need to assign?

Arkansas Subscriber

Answer: You’ll assign M24.574 (Contracture, right foot) to report the patient’s contracture of the right foot. According to ICD-10-CM, a joint contracture “results from connective tissue (tendon, muscle, ligament) that becomes stiff or constricted.”

Under Contraction(s), contracture, contracted in the ICD-10-CM code set Alphabetic Index, you’ll find joint > foot joint. This leads you to M24.57- (Contracture, ankle and foot), which you’ll notice carries a 6th character required icon when you verify the code in the tabular list. The 6th character specifies the type of joint, ankle or foot, and laterality. Since the encounter notes indicate the condition is localized to the patient’s right foot, you’ll assign M24.574.

Parent code Excludes1 note: Parent code M24.5- (Contracture of joint) features an Excludes1 note listing the M62.4- (Contracture of muscle) code family, which includes synonyms like “contracture of muscle without contracture of joint” and “contracture of tendon (sheath) without contracture of joint.” The note also includes M72.0 (Palmar fascial fibromatosis [Dupuytren]), which features a synonym of “Dupuytren’s contracture.”

What this means: If your provider assigns both a joint contracture code, such as M24.574, and a muscle contracture code, such as M62.471 (Contracture of muscle, right ankle and foot) together, then the Excludes1 note instructs you to assign only the joint contracture code in your claim as it includes the muscle contracture.