ICD-10 Coding for Lumbar Degenerative Disc Disease(M51.36, M51.37)
Complete ICD-10-CM coding and documentation guide for Lumbar Degenerative Disc Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumbar Degenerative Disc Disease
M51.3-M51.37Primary Range
Other intervertebral disc degeneration
This range covers lumbar and lumbosacral degenerative disc disease, which is the primary focus for coding this condition.
Low back pain and vertebrogenic pain
These codes are used to describe associated pain conditions that may accompany lumbar degenerative disc disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.36 | Other intervertebral disc degeneration, lumbar region | Use when MRI confirms lumbar disc degeneration with discogenic pain. |
|
| M51.37 | Other intervertebral disc degeneration, lumbosacral region | Use when MRI confirms lumbosacral disc degeneration with discogenic pain. |
|
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 degenerative disc disease
Essential facts and insights about Lumbar Degenerative Disc Disease
Primary ICD-10-CM Codes for lumbar degenerative disc disease
Decision Criteria
clinical Criteria
- Presence of discogenic pain confirmed by imaging
documentation Criteria
- Detailed pain description and imaging findings
Applicable To
- Lumbar discogenic pain
Excludes
- Vertebrogenic pain (M54.51)
Clinical Validation Requirements
- MRI showing disc degeneration
- Pain reproduction on discography
Code-Specific Risks
- Misclassification with vertebrogenic pain codes
Coding Notes
- Ensure documentation specifies discogenic origin to avoid miscoding.
M51.37 - Other intervertebral disc degeneration, lumbosacral region
Use when MRI confirms lumbosacral disc degeneration with discogenic pain.
Applicable To
- Lumbosacral discogenic pain
Excludes
- Vertebrogenic pain (M54.51)
Clinical Validation Requirements
- MRI showing lumbosacral disc degeneration
- Pain reproduction on discography
Coding Notes
Ensure documentation specifies discogenic origin to avoid miscoding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sciatica, left side
M54.42Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lumbar Degenerative Disc Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.36.
Impact
Clinical: Leads to incomplete diagnosis documentation., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Ensure imaging results are included in clinical documentation, Use templates to guide comprehensive documentation
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Use specific codes like M51.36 or M51.37 based on imaging and clinical findings.
Impact
Reimbursement: Incorrect coding can affect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts clinical data integrity.
Mitigation Strategy
Differentiate based on imaging findings and pain origin.
Impact
Risk of audits due to use of non-specific codes.
Mitigation Strategy
Use specific codes and ensure thorough documentation.
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 Lumbar Degenerative Disc Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumbar Degenerative Disc Disease
Use these documentation templates to ensure complete and accurate documentation for Lumbar Degenerative Disc Disease. These templates include all required elements for proper coding and billing.
Chronic lumbar discogenic pain
Specialty: OrthopedicsRequired Elements
- Pain location and severity
- Imaging findings
- Neurological exam results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Lumbar Degenerative Disc Disease? Ask your questions below.