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M20.40
ICD-10-CM
Hammer Toe

Find information on hammer toe diagnosis, including clinical documentation, medical coding, and ICD-10 codes. Learn about hammer toe symptoms, treatment options, and relevant healthcare procedures. This resource covers M71.4, M71.5, and related podiatry coding guidelines for accurate medical billing and documentation. Explore hammer toe deformities, flexible hammer toe, rigid hammer toe, and surgical intervention details for healthcare professionals and patients seeking information.

Also known as

Hammertoe
Toe Deformity

Diagnosis Snapshot

Key Facts
  • Definition : A foot deformity where the toe bends abnormally at the middle joint.
  • Clinical Signs : Bent toe, pain, corns, calluses, difficulty wearing shoes.
  • Common Settings : Orthopaedic clinics, podiatrist offices, physical therapy centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M20.40 Coding
M20.4

Hammer toe

Acquired hammer toe deformity.

M20.5

Claw toe

Acquired claw toe deformity.

M20.6

Other deformities of toe(s)

Deformities like overlapping toes, mallet toe.

Q66.8

Other congenital deformities of feet

Congenital deformities including hammer toe.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the hammer toe acquired or congenital?

  • Acquired

    Is it associated with a corn or callus?

  • Congenital

    Is it associated with other deformities?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Bent toe joint, usually second toe
Claw toe, several joints bent
Mallet toe, bent tip

Documentation Best Practices

Documentation Checklist
  • Hammer toe ICD-10 code (M20.4)
  • Affected toe(s) (right, left, 2nd, 3rd, etc.)
  • Pain level and impact on ambulation
  • Presence of calluses or corns
  • Conservative or surgical treatment plan

Coding and Audit Risks

Common Risks
  • Laterality Coding Errors

    Missing or incorrect right/left designation for hammer toe, leading to claim rejections or inaccurate data analysis. Medical coding, ICD-10, healthcare compliance.

  • Unspecified Hammer Toe

    Using unspecified codes (e.g., M20.4) when a more specific code exists, impacting reimbursement and data quality. CDI, clinical documentation improvement, medical coding audits.

  • Associated Condition Coding

    Failing to code associated conditions like arthritis or diabetes, impacting risk adjustment and appropriate reimbursement. ICD-10, medical coding guidelines, healthcare compliance.

Mitigation Tips

Best Practices
  • Proper footwear fitting: Wide toe box, avoid high heels. ICD-10: M20.4
  • Padding and orthotics: Cushion hammer toe, realign joints. CPT: 29799
  • Stretching exercises: Improve flexibility, reduce contractures. SNOMED CT: 302445007
  • Splinting or taping: Stabilize toe, maintain proper alignment. HCPCS: L3030
  • Pain management: NSAIDs, ice, injections. Document severity for accurate coding.

Clinical Decision Support

Checklist
  • 1. Visual exam: Curled toe, elevated middle joint
  • 2. Palpation: Corn or callus on toe, joint stiffness
  • 3. ROM assessment: Limited toe flexibility, pain
  • 4. X-ray (if needed): Confirm bone alignment, arthritis

Reimbursement and Quality Metrics

Impact Summary
  • Hammer Toe Reimbursement: CPT 28285, ICD-10 M20.4, accurate coding maximizes payment.
  • Coding accuracy impacts hospital reporting for Hammer Toe, affecting quality metrics.
  • Proper documentation crucial for Hammer Toe claims, avoids denials, improves revenue cycle.
  • Hammer Toe quality metrics: Post-op infection rates, pain management, patient satisfaction.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code M20.4 for hammer toe
  • Specify affected toe
  • Laterality is key: Left/Right
  • Document deformity cause
  • Check for associated conditions

Documentation Templates

Patient presents with complaints consistent with hammer toe deformity affecting the [specify digit, e.g., second toe] of the [right/left] foot.  Symptoms include [list symptoms, e.g., pain, stiffness, difficulty walking, corn formation, metatarsalgia, dorsal flexion contracture].  On physical examination, the affected toe exhibits flexion at the proximal interphalangeal (PIP) joint with [describe the distal interphalangeal (DIP) joint position, e.g., extension or flexion].  [Describe the presence or absence of calluses, corns, and their location, e.g.,  A corn is present on the dorsum of the PIP joint].  Range of motion is limited in the affected toe.  Assessment: Hammer toe deformity [specify, e.g., flexible, rigid] of the [specify digit] toe, [right/left] foot, likely secondary to [potential etiology if known, e.g.,  biomechanical abnormalities, tight footwear, rheumatoid arthritis].  Differential diagnosis includes claw toe, mallet toe, and osteoarthritis.  Plan:  Conservative treatment options including [specify treatment, e.g.,  padding, orthotics, splinting, wider shoes, exercises] were discussed.  Patient education provided regarding proper shoe fit and foot care.  If conservative measures fail, surgical intervention, such as hammer toe repair or arthroplasty, will be considered.  Follow-up scheduled in [duration, e.g., four weeks] to assess treatment response.  ICD-10 code: [specify, e.g., M20.52] will be used for billing and coding purposes.
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