ICD-10 Coding for Facet Arthropathy Lumbar(M46.96)
Complete ICD-10-CM coding and documentation guide for Facet Arthropathy Lumbar. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Facet Arthropathy Lumbar
M46-M47Primary Range
Other inflammatory spondylopathies and spondylosis
This range includes codes for inflammatory and degenerative conditions affecting the spine, including facet arthropathy.
Key Information: ICD-10 code for facet arthropathy lumbar
Essential facts and insights about Facet Arthropathy Lumbar
Primary ICD-10-CM Code for facet arthropathy lumbar
Decision Criteria
clinical Criteria
- Facet joint degeneration confirmed by imaging
documentation Criteria
- Explicit mention of 'facet arthropathy'
Applicable To
- Facet arthropathy lumbar
Excludes
- Spondylosis with myelopathy (M47.86)
Clinical Validation Requirements
- Imaging showing facet joint degeneration
- Physical exam findings such as pain on extension or rotation
Code-Specific Risks
- Incorrectly coding as spondylosis when facet arthropathy is documented
Coding Notes
- Ensure documentation specifies lumbar region and facet arthropathy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Low back pain
M54.5Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Facet Arthropathy Lumbar to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M46.96.
Impact
Clinical: Misdiagnosis or inappropriate treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims
Mitigation Strategy
Ensure detailed documentation of symptoms and diagnosis, Use specific terminology like 'facet arthropathy'
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Follow the ICD-10 index which directs to M46.96 for facet arthropathy.
Impact
Using M47.86 instead of M46.96 for facet arthropathy.
Mitigation Strategy
Educate coders on the importance of following the ICD-10 index.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Facet Arthropathy Lumbar, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Facet Arthropathy Lumbar
Use these documentation templates to ensure complete and accurate documentation for Facet Arthropathy Lumbar. These templates include all required elements for proper coding and billing.
Chronic Lumbar Pain Management
Specialty: Pain ManagementRequired Elements
- Diagnosis of facet arthropathy
- Imaging results
- Response to diagnostic blocks
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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