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Flat Feet ICD 9 – Congenital Vs Acquired

Flat Feet ICD 9 – Congenital vs acquired pes planus coding for diagnosis and medical billing purposes
Flat Feet ICD 9 – Congenital vs acquired pes planus coding for diagnosis and medical billing purposes
Touseef Riaz
Written by Touseef Riaz Founder, UControl Billing

Flat feet are a kind of foot deformity that can either be present at the time of birth or be acquired later in life for different reasons. It can be recognized by the absence of the arch found in the feet. Having a low arch or no arch at all means that your whole feet lie flat on the ground, hence the name ‘flat feet’. In medical terminology, flat feet are called pes planus. Flat Feet ICD 9 – Congenital vs Acquired coding is used to classify pes planus based on whether the condition is present at birth or develops later in life.

Flat Feet ICD 9 – Congenital Vs Acquired

Given the two primary types of flat feet, namely congenital and acquired, below are the corresponding codes for each:

1. Flat Feet (Acquired) – 734

From the 2012 ICD-9-CM, the diagnosis code for acquired flat feet is 734, which can be used to indicate a diagnosis for reimbursement purposes. The code is valid for claims with a date of service before September 2015, since the ICD 9 was effectively replaced by the ICD 10 code after that. The relevant ICD 10 code for 734 is M21.40 Flat foot (acquired).

The code excludes the cases dealing with a congenital flat foot, rigid flat foot, and everted flat foot.

2. Flat Feet (Congenital) – 754.61

754.61 represents the ICD 9 code for congenital pes planus that can be used to show a diagnosis for reimbursement and claims process. The code is valid for claims with a date of service before September 2015, since the ICD 9 was effectively replaced by the ICD 10 code after that. The relevant ICD 10 code for congenital flat feet is Q66.50 Congenital Flat foot (acquired).

For a medical biller or coder, it is imperative to have a thorough knowledge of the different types and problems associated with the deformity, to ensure that coding is done accurately, leading to correct and speedy reimbursement for the medical practice. In this article, that is exactly what we discuss: the different causes leading to flat feet, their types, and the commonly associated ICD 9 code for flat feet.

The process of coding and submitting claims for the medical services provided is documented carefully.

What are Flat feet?

Flat feet, also known as pes planus or fallen arches, are a serious deformity with various degrees of physical impact. The condition can be passed down to the next generation as a hereditary trait, or it may develop later in life due to various factors. The condition is characterized by no arch, which means that the entire sole touches the ground when standing.

Causes

Flat feet are more common in infants, with the major cause being heredity. The condition is identified when the Achilles tendon is tight or due to the laxity of ligaments. In children, the condition can develop if there’s a lack of foot exercise.

For adults, flat feet can develop from a foot injury, continued stress on the foot arches, abnormal joint formation, obesity, arthritis, diabetes, or the tightness of the Achilles tendon.

Identifying Flat Feet

The major identifier for the condition is the lack of arches found in the feet, resulting in pain and fatigue along the inner sides of your feet. Other symptoms to look for include: heel and ankle pain, lower back pain, abnormal walking pattern, rolled in ankles, and shin splints.

Types of flat feet

In general, flat feet are categorized into two groups: Congenital pes planus, which is present from birth, or acquired flat feet, which develop in adulthood. They are further segmented into the following types:

  • Flexible Flat Feet

This is the most common type in which the arches are visible when a person is not standing, but disappear as soon as they stand up and put weight on their feet. This type develops in early childhood and gets worse gradually with age. Due to the absence of arches, the ligaments and tendons in the feet can tear, swell, and stretch.

  • Rigid Flat Feet

A person with rigid flat feet does not have any arches even when they are sitting. This condition develops in the teens and gradually worsens as the person gets older.

  • Fallen Arch

A fallen arch is an example of an adult-acquired type, where the foot’s arch collapses unexpectedly. This causes the foot to turn outward, causing immense pain. A fallen arch can result from inflammation or a tear in the leg tendon that supports the foot arch.

  • Vertical Talus

This is a congenital disability, meaning that babies are born with this deformity that prevents the arches of the feet from forming altogether. The talus bone, found in the ankle, is in the wrong position.

Purpose of Flat Feet ICD 9 Coding

Accurately coding all medical procedures and services is crucial for claims processing and reimbursement. Additional benefits include:

  • Formally Documenting and Capturing Information about Flat Feet: 

ICD 9 codes for flat feet enable medical coders to correctly specify the complete details about the condition, including information such as whether the disability is congenital or acquired and if one foot is affected or both. This helps in maintaining and improving the global data on conditions that help in research and data collection.

  • Congenital or Acquired?

One of the most important differentiating factors that needs to be highlighted when coding for the condition is whether the patient has acquired or congenital flat feet. This information is imperative for reporting when it comes to coding with ICD.

  • Keeping in Mind the Exclusions

Another thing to keep in mind when coding for flat feet ICD 9 is to check for the notes mentioned under the specific category. The notes specify the different synonyms for the condition, as well as the exclusions. The coder needs to be careful when coding to avoid any mistakes in reporting the diagnosis. If there are errors in the reporting and coding, it will definitely cause issues during the claim process, creating hassle for the patient as well as the practice.

Outsourcing Medical Coding and Billing Services

The ICD is considered by healthcare professionals as a universal language through which doctors and healthcare providers communicate regarding the thousands of health conditions and diseases. The codes are expanded each year with frequent inclusions to incorporate as much information as possible. It is for this reason that the accurate reporting of these medical codes is essential for any medical practice or hospital.

Looking to outsource your medical billing and coding process? Look no further than UControl Billing, the complete solution to all your coding problems. UControl Billing has the best infrastructure and the required expertise in the industry, providing medical billing and coding services to global clients.

Partnering with control Billing means that you do not have to worry about managing your revenue cycle, as our team of expert medical coders takes over your coding process to ensure all claims are correctly documented and processed on time!

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Touseef Riaz, Founder and CEO of UControl Billing
Author & Revenue Cycle Management Expert

Founder & CEO at UControl Billing

10+ Years RCM Expertise HIA-LI Member MGMA Member Healthcare Revenue Cycle

A couple of years ago, I executed the effective plan of creating a Medical billing and Coding company named UControl Billing. The company aims to bring revolutionary advancements to foster medical billing and coding revenues. As an official member of HIA-LI and MGMA, I feel honored in providing networking opportunities, problem-solving, and improving the revenue management cycle.

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