Orthopedic Coding Alert

Reader Questions:

2 Effusions Mean 1 Effusion Dx Code

Question: If a patient suffers from effusion of the same ankle and foot, should I submit two ICD-10 codes? Or is there a combination code for this diagnosis?

Texas Subscriber

Answer: You should report two codes, but it can be a bit confusing due to the parent code’s descriptor.

The parent code for both conditions is M25.47- (Effusion, ankle and foot). From there, the parent code splits into these options:

  • M25.471 (Effusion, right ankle)
  • M25.472 (Effusion, left ankle)
  • M25.473 (Effusion, unspecified ankle)
  • M25.474 (Effusion, right foot)
  • M25.475 (Effusion, left foot)
  • M25.476 (Effusion, unspecified foot)

So, let’s say a patient suffers from right ankle and foot effusion. On the claim, you’d report M25.471 and M25.474.