2025 ICD-10-CM code Q76.3
Congenital scoliosis due to congenital bony malformation.It is characterized by hemivertebra fusion or failure of segmentation with scoliosis.
Medical necessity for services related to Q76.3 must be established by demonstrating the impact of the congenital scoliosis on the patient's function and health. This may include documentation of pain, limitations in mobility, or respiratory compromise (in severe cases).Justification for interventions such as bracing or surgery should be clearly documented.
Diagnosis and management of congenital scoliosis typically falls under the purview of specialized physicians like orthopedic surgeons, particularly those with expertise in pediatric orthopedics or spinal deformities. They are responsible for assessing the curvature, determining the underlying cause, and recommending appropriate treatment strategies.
In simple words: This code indicates scoliosis (a sideways curvature of the spine) that is present at birth and caused by a malformation in the bones of the spine.
Congenital scoliosis due to congenital bony malformation such as hemivertebra fusion or failure of segmentation with scoliosis. This code is specifically for scoliosis resulting from a congenital bony malformation.
Example 1: A newborn infant is diagnosed with hemivertebrae (incomplete formation of vertebrae) during a routine spinal examination. Imaging studies confirm the presence of a scoliosis curve attributed to the hemivertebrae. Q76.3 is used to document this condition., A 6-year-old child presents with a progressive curvature of the spine. Radiographic analysis reveals a congenital bony malformation leading to segmentation failures in the thoracic spine, resulting in scoliosis. Q76.3 accurately represents this diagnosis., A teenager undergoing a pre-sports physical is found to have a mild scoliosis. Detailed imaging studies uncover a previously undiagnosed congenital fusion of vertebral segments, consistent with the features of congenital scoliosis. This condition is coded as Q76.3.
Thorough documentation is crucial for accurate coding. It should include details of the congenital bony malformation (e.g., hemivertebrae, segmentation defects), radiographic findings confirming scoliosis, and any associated clinical features. Specific measurements of the scoliosis curve (Cobb angle) should be recorded.
** Distinguishing Q76.3 from other scoliosis codes requires careful attention to the underlying cause.Only scoliosis due to congenital bony malformations should be assigned this code. Other types of scoliosis, such as those caused by neuromuscular conditions or idiopathic scoliosis, are coded differently.
- Specialties:Orthopedic Surgery, Pediatric Orthopedics, Genetics
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital