How to Use the ICD-10 Code for Difficulty in Walking

Navigating the complexities of medical diagnoses involves understanding a language all its own, one that speaks through alphanumeric codes like the International Classification of Diseases (ICD) system. Rehab therapists spend much of their time trying to parse that foreign tongue to determine the right ICD-10 code. One ICD-10 code that is often a cause for consternation is the ICD-10 code for difficulty in walking. 

This seemingly simple phrase carries a multitude of potential causes, symptoms, and implications, all distilled into a concise code that rehab therapists must utilize for documentation, billing, and statistical purposes. So to help elucidate an otherwise murky subject, let’s delve into the nuances of the ICD-10 code for difficulty in walking, shedding light on its significance and when best to apply the difficulty in walking ICD-10 code.

What is Difficulty in Walking?

While it’s a very general phrase, the difficulty in walking ICD-10 code applies to common musculoskeletal impairments that result in a patient being unable or increased hardship in ambulation. Joint dysfunction (e.g., different forms of arthritis), bony abnormalities, circulation (e.g., peripheral vascular disease), or even pain can make it difficult to walk with a normal gait. Granted, there are also ICD-10 codes specific to some of these dysfunctions—which is why whenever you are coding for ICD-10, specificity reigns supreme. 

What is the ICD-10 Code for Difficulty in Walking?

Simply stated, the ICD-10 code for difficulty in walking is R26.2, but as is often the case in rehab therapy, there is more to the story. Difficulty in walking falls under the ICD-10 chapter R, which pertains to symptoms, signs, and abnormal clinical and lab findings. It’s another general description, but the classification pertains to a global or systemic condition for the patient and not a specific joint or singular tissue. 

Patients who have difficulty walking may have a history of falls and an increased risk for falls. Be wary of using any specific fall codes with the difficulty in walking ICD-10 code, though, as they are not codable together under ICD-10 guidelines. This pairing would follow under a type 1 excludes note and should not be coded together. The diagnoses that fall under the Excludes 1 criteria are: 

• R26.81; unsteadiness on feet
• R29.6; falling

When Would Rehab Therapists Use ICD-10 for Difficulty in Walking?

Two other common ICD-10 codes found within the R chapter of ICD-10—and another source of confusion for rehab therapists—are R26.89 (other abnormalities of gait and mobility) and R26.9 (unspecified abnormalities of gait and mobility.) As all three of these diagnoses sound somewhat similar as they all deal with ambulation in some form, you may be asking yourself, “When do I use difficulty in walking?” 

To answer this question, let’s first differentiate between the two gait abnormality codes and the difficulty in walking ICD-10 code. The gait abnormality codes are more commonly seen in neurological cases or cases of congenital deformities, whereas difficulty in walking applies to a more global musculoskeletal dysfunction. For example, patients coming to the clinic with a medical diagnosis of peripheral vascular disease or osteoarthritis of multiple joints may have a primary complaint and dysfunction of an inability to ambulate for community and household mobility effectively—or they may have a pervasive weakness gait disorder. These patients would be good candidates for the ICD-10 code for difficulty in walking.

What Are Good Resources for Rehab Therapists to Find ICD-10 Codes?

John Wallace, PT, MS, OCS, Chief Compliance Officer at WebPT has noted the continued difficulty rehab therapists have when correctly coding ICD-10. He recommends rehab therapists use their current EMR’s tools to search for the appropriate diagnosis, or—if necessary—look to outside assistance in the form of the free database ICD10data where over 69,000 codes can be searched. 

What if Your Insurance Payer Is Not Reimbursing for Difficulty in Walking?

If a patient evaluation and plan of care is denied due to your use of the ICD-10 code for difficulty in walking, start by checking that your documentation supports the code you used and confirming it makes sense based on the above information. If you continue to have difficulty with a particular insurance payer, a phone call may be necessary. 

Unfortunately, insurance rules are convoluted and don’t always adhere to best practices—nor do they provide much transparency. The best course of action is to call the specific insurance payer representative.

How Can Technology Help with ICD-10 Codes?

Aside from knowing how to assign the correct ICD-10 code to each patient’s case, there are many automated workflows that the best EMRs have built into their software. For example, WebPT uses an intuitive purpose-built Practice Experience Management platform for rehab therapists that eliminates extra clicks and the need to leave your software and do a Google search. After all, in today’s age, shouldn’t the software you use be an asset in creating the ideal practice experience?