ICD-10 Coding for Facet Arthropathy(M47.816, M47.812)
Complete ICD-10-CM coding and documentation guide for Facet Arthropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Facet Arthropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M47.816 | Spondylosis with myelopathy or radiculopathy, lumbar region | Use for lumbar facet arthropathy with degenerative changes. |
|
| M47.812 | Spondylosis with myelopathy or radiculopathy, cervical region | Use for cervical facet arthropathy with degenerative changes. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for lumbar facet arthropathy
Essential facts and insights about Facet Arthropathy
Primary ICD-10-CM Codes for facet arthropathy
Decision Criteria
clinical Criteria
- Presence of degenerative changes on imaging
Applicable To
- Lumbar facet arthropathy
Excludes
- Inflammatory spondylopathy (M46.96)
Clinical Validation Requirements
- Degenerative changes on imaging
- Pain on extension and rotation
Code-Specific Risks
- Confusion with inflammatory codes
Coding Notes
- Ensure documentation specifies degenerative nature.
M47.812 - Spondylosis with myelopathy or radiculopathy, cervical region
Use for cervical facet arthropathy with degenerative changes.
Applicable To
- Cervical facet arthropathy
Excludes
- Inflammatory spondylopathy (M46.92)
Clinical Validation Requirements
- Cervical facet osteoarthritis on imaging
- Pain aggravated by neck extension
Coding Notes
Document specific cervical levels affected.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M47.816.
Impact
Clinical: Lack of specificity affects treatment planning., Regulatory: Fails to meet coding specificity requirements., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Always specify the underlying cause of pain., Use imaging to support diagnosis.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Misclassification affects compliance with coding guidelines., Data Quality: Impacts the accuracy of clinical data.
Mitigation Strategy
Use M47.8- codes for degenerative facet arthropathy.
Impact
Using unspecified codes like M46.92 can trigger audits.
Mitigation Strategy
Ensure documentation is specific and supports the chosen code.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Facet Arthropathy
Use these documentation templates to ensure complete and accurate documentation for Facet Arthropathy. These templates include all required elements for proper coding and billing.
Chronic lumbar facet arthropathy
Specialty: Pain ManagementRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Facet Arthropathy? Ask your questions below.