ICD-10-CM · Foot & ankle

M20.11

M20.11 identifies an acquired lateral deviation of the great toe at the first metatarsophalangeal joint, confirmed on the right foot, resulting from structural changes rather than a congenital condition.

Verified May 8, 2026 · 5 sources ↓

Status
Billable
Chapter
13
Related CPT
11
Region
Foot & ankle
Drawn from CDCAAPCIcdcodesAssociationdatabase

Documentation tips

What should appear in the chart to support M20.11.

Source · Editorial brief grounded in 5 cited references ↓

  • Document laterality explicitly as 'right foot' — M20.11 is not valid without confirmed right-side involvement.
  • Record weight-bearing radiograph findings, including hallux valgus angle (HVA) and intermetatarsal angle (IMA), to support medical necessity for surgical intervention.
  • Specify 'acquired' versus congenital origin; a pediatric or congenital deformity should be evaluated under Q66.2– rather than M20.11.
  • If bursitis or metatarsalgia is separately documented, add M76.62 or M77.51 as additional diagnoses — do not fold them into M20.11.
  • For surgical cases, document failed conservative management (orthotics, padding, shoe modification) to support pre-authorization and audit defense.

Related CPT procedures

Procedure codes commonly billed with M20.11. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M20.11 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Reporting M20.11 and M21.611 together for the same foot — these codes carry an Excludes1 relationship and cannot be billed simultaneously for the same encounter.
  • Using M20.11 for a congenital great-toe deformity; acquired and congenital conditions map to distinct code families (M20.1– vs. Q66.2–).
  • Omitting laterality and defaulting to an unspecified code when the operative or clinical note clearly documents the right foot — this triggers specificity downcoding and potential payer rejection.
  • Applying M20.11 when the documentation only describes a bony bump with no angular deformity measurement — that presentation maps to M21.611, not M20.11.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M20.11 applies when a patient presents with a documented acquired hallux valgus deformity of the right foot — typically confirmed by weight-bearing radiographs showing a hallux valgus angle (HVA) greater than 15° and, for surgical cases, an intermetatarsal angle (IMA) of 12° or more. The 'acquired' qualifier rules out congenital conditions; if deformity is congenital or present since birth, evaluate Q66.2– instead.

M20.11 and M21.611 (Bunion of right foot) are frequently confused but are mutually exclusive via Excludes1 notes. Use M20.11 when the angular structural deformity is the primary finding — especially in surgical workups. Use M21.611 when documentation describes a medial bony prominence at the first MTP joint without significant angular deformity. Do not report both for the same encounter.

For bilateral hallux valgus, report M20.11 (right) and M20.12 (left) together — there is no single bilateral code in this family. Ancillary codes such as M77.51 (metatarsalgia) or M76.62 (bursitis of foot) may be added when separately documented and clinically supported.

Sibling codes

Other billable codes under M20.1 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between M20.11 and M21.611?
M20.11 describes an acquired angular structural deformity of the great toe (hallux valgus) and is the correct code when radiographic angle criteria are met. M21.611 describes a bunion — a medial bony prominence at the first MTP — without significant angular deformity. They are Excludes1 to each other and cannot be reported together for the same foot at the same encounter.
02Can I use M20.11 for bilateral hallux valgus?
No. There is no single bilateral code in the M20.1– family. Report M20.11 for the right foot and M20.12 for the left foot on the same claim when bilateral involvement is documented.
03What radiographic findings support M20.11?
A hallux valgus angle (HVA) greater than 15° on a weight-bearing anteroposterior foot radiograph supports the diagnosis. For surgical cases, an intermetatarsal angle (IMA) of 12° or more is typically required to justify operative intervention.
04Is M20.11 appropriate for a congenital toe deformity?
No. M20.11 is explicitly for acquired deformities. Congenital hallux deformities should be evaluated under Q66.2– codes based on specific findings and pediatric orthopedic documentation.
05Which CPT codes are typically paired with M20.11 for bunionectomy?
Common pairings include 28292 (Keller/McBride procedure), 28296 (Austin/Chevron osteotomy), 28297 (Lapidus procedure with first met-cuneiform arthrodesis), and 28299 (complex osteotomy). CPT selection depends on the specific surgical technique documented — verify modifier requirements (e.g., -RT) with individual payers.
06Can M20.11 be reported with metatarsalgia or bursitis codes?
Yes, when separately documented. M77.51 (metatarsalgia, right foot) and M76.62 (bursitis of foot) can be added as secondary diagnoses if clinical findings support them independently of the hallux valgus deformity.
07Does M20.11 require a 7th-character extension?
No. M20.11 is an M-code (musculoskeletal, non-injury) and does not use 7th-character extensions. Those apply to S-codes (traumatic injury codes) only.

Mira AI Scribe

Mira's AI scribe captures the affected side (right), radiographic angle measurements (HVA, IMA) from weight-bearing X-ray findings, severity of deformity, and any prior conservative treatment documented in the visit note. This prevents a specificity downgrade to an unspecified code, shields against M21.611 substitution errors, and provides the audit trail needed for surgical pre-authorization.

See how Mira captures M20.11 documentation

Related ICD-10 codes

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