ICD-10 Coding for Metatarsalgia(M77.41, M77.42)
Complete ICD-10-CM coding and documentation guide for Metatarsalgia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metatarsalgia
M77.4-Primary Range
Metatarsalgia
This range covers the primary diagnosis of metatarsalgia, specifying laterality.
Morton's Neuroma
Used when interdigital nerve pain is present, often associated with metatarsalgia.
Primary Osteoarthritis, Ankle/Foot
Used when osteoarthritis is present in conjunction with metatarsalgia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M77.41 | Metatarsalgia, right foot | Use when metatarsalgia is confirmed in the right foot with specific clinical findings. |
|
| M77.42 | Metatarsalgia, left foot | Use when metatarsalgia is confirmed in the left foot with specific clinical findings. |
|
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 metatarsalgia
Essential facts and insights about Metatarsalgia
Primary ICD-10-CM Codes for metatarsalgia
Decision Criteria
clinical Criteria
- Presence of localized pain under metatarsal heads with positive squeeze test
Applicable To
- Pain localized to metatarsal heads of the right foot
Excludes
- General foot pain (M79.67-)
Clinical Validation Requirements
- Localized pain under metatarsal heads
- Aggravated by weight-bearing or tight footwear
- Positive metatarsal squeeze test
Code-Specific Risks
- Incorrectly using for general foot pain without specific metatarsal involvement
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
M77.42 - Metatarsalgia, left foot
Use when metatarsalgia is confirmed in the left foot with specific clinical findings.
Applicable To
- Pain localized to metatarsal heads of the left foot
Excludes
- General foot pain (M79.67-)
Clinical Validation Requirements
- Localized pain under metatarsal heads
- Aggravated by weight-bearing or tight footwear
- Positive metatarsal squeeze test
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Metatarsalgia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M77.41.
Impact
Clinical: Leads to inaccurate diagnosis recording, Regulatory: Non-compliance with ICD-10 coding standards, Financial: Potential for claim denials or reduced reimbursement
Mitigation Strategy
Always document the affected foot, Use specific codes for right or left foot
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Decreases accuracy of health records
Mitigation Strategy
Document laterality to use M77.41 or M77.42
Impact
Using unspecified codes can trigger audits due to lack of specificity.
Mitigation Strategy
Always document and code the specific foot affected.
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 Metatarsalgia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metatarsalgia
Use these documentation templates to ensure complete and accurate documentation for Metatarsalgia. These templates include all required elements for proper coding and billing.
Patient with metatarsalgia and Morton's neuroma
Specialty: PodiatryRequired Elements
- Subjective complaints
- Physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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