Health Information Management

Bunions

JustCoding News: Inpatient, November 11, 2009

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Bunions, a common problem, typically manifests as a bony protuberance at the base of a patient’s big toe or toes. A bunion is more complicated than a simple bump on the foot. The big toe of someone with a bunion angles in toward the other toes, putting pressure on that joint and causing pain.

Bunions are most common in women and sometimes run in families. The cause is almost always unsuitable footwear.

Types/stages

There are no additional types/stages of bunions.

Signs and symptoms
Bunions and their associated symptoms occur gradually. They are sometimes confused with symptoms of gout, but gout pain comes on suddenly and can be more severe.

Signs of bunions include the following:

  • Red, calloused skin or bony bump along the big toe inside edge
  • Pain over the joint, aggravated by pressure from shoes
  • Big toe turned in toward the other toes

Treatment

Clinicians usually try nonsurgical treatment first to decrease pressure on the big toe and relieve pain. Treatment includes suggesting that the patient wear roomy shoes or use bunion pads, arch supports, or custom-made orthotics that redistribute weight when walking to reduce pressure on the big toe. Nonprescription medicine, such as ibuprofen or aspirin, also can relieve pain and reduce swelling.

When nonsurgical treatment does not relieve toe pain and the patient is unable to accomplish normal daily activities, clinicians may consider surgery to help restore normal alignment in the toe joint.

Documentation and coding

ICD-9-CM coding

  • Bunion: Report code 727.1

ICD-10 coding

  • Hallux valgus (acquired), unspecified foot: Report code M20.10
  • Hallux valgus (acquired), right foot: Report code M20.11
  • Hallux valgus (acquired), left foot: Report code M20.12



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