Q66.40 Congenital talipes calcaneovalgus, unspecified foot

ICD10CM code

#### Name of the Condition
- Congenital Talipes Calcaneovalgus, Unspecified Foot
- Often referred to as calcaneovalgus foot or positional foot deformity.

#### Summary
- Congenital talipes calcaneovalgus is a foot deformity seen in newborns where the foot points upwards and outward. This condition is generally detected at birth and affects the flexibility of the ankle joint, with the foot positioned in a markedly dorsiflexed and everted alignment.

#### Causes
- The condition is often due to positioning in the womb and is associated with increased uterine pressure or cramped space, especially in firstborn children.
- No genetic factors are strongly linked; it is often a developmental positioning issue.

#### Risk Factors
- Being the first child (firstborn status).
- Space restrictions during pregnancy (such as with twins or large babies).
- Breach presentation or abnormal positioning in the womb.

#### Symptoms
- The foot appears overly dorsiflexed (the toes are pulled upwards towards the shin) and everted (turned outwards).
- Limited ankle movement.
- Generally, the condition is not painful for the newborn.

#### Diagnosis
- Physical examination after birth is usually sufficient for diagnosis.
- In some cases, imaging like X-rays may be used to rule out bone abnormalities.

#### Treatment Options
- Stretching exercises and physical therapy are often the main treatment and help improve joint flexibility.
- In rare cases where movement is very restricted, casting or bracing may be used.
- Surgery is hardly ever needed unless a more severe underlying structural problem is identified.

#### Prognosis and Follow-Up
- The prognosis is generally favorable with appropriate management.
- Most children see a full resolution of symptoms with early interventions.
- Regular follow-up is crucial to monitor foot development and address any residual stiffness early.

#### Complications
- If left untreated, may lead to persistent foot deformity affecting gait.
- Potential development of secondary orthopedic issues if severe or mismanaged.

#### Lifestyle & Prevention
- There are no specific lifestyle changes known to prevent this congenital condition due to its nature as a birth positioning issue.
- Prenatal care and routine ultrasounds can sometimes detect foot position issues early.

#### When to Seek Professional Help
- If stretching exercises are not improving foot mobility by 6-12 months.
- If there are signs of abnormal gait as the child begins to walk.

#### Additional Resources
- [American Pediatric Surgical Association](https://www.pedsurg.org)
- [American Academy of Pediatrics](https://www.aap.org)
- Local parenting or congenital condition support groups.

#### Tips for Medical Coders
- Ensure clear documentation if the foot (left or right) is specified, although unspecified is acceptable under Q66.40.
- Be aware of similar congenital conditions to avoid miscoding (e.g., clubfoot, which has a different ICD code).
- Verify if the case involves any surgical procedures for accurate reporting of additional codes.

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