ICD-10 Coding for Lumbar Spondylosis with Radiculopathy(M47.27, M51.16)
Complete ICD-10-CM coding and documentation guide for Lumbar Spondylosis with Radiculopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumbar Spondylosis with Radiculopathy
M47.2-M47.9Primary Range
Other spondylosis with radiculopathy
This range includes codes for spondylosis with radiculopathy, specifically affecting the lumbosacral region.
Intervertebral disc disorders with radiculopathy
This range is relevant when radiculopathy is due to intervertebral disc disorders rather than spondylosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M47.27 | Other spondylosis with radiculopathy, lumbosacral region | Use when radiculopathy is caused by spondylosis in the lumbosacral region. |
|
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region | Use when radiculopathy is caused by a herniated disc. |
|
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 spondylosis with radiculopathy
Essential facts and insights about Lumbar Spondylosis with Radiculopathy
Primary ICD-10-CM Codes for lumbar spondylosis with radiculopathy
Decision Criteria
clinical Criteria
- Presence of imaging evidence showing spondylosis and nerve root compression
coding Criteria
- Use M47.27 when spondylosis is the confirmed cause of radiculopathy
documentation Criteria
- Document specific levels affected and symptoms correlating to nerve compression
Applicable To
- Lumbosacral spondylosis with radiculopathy
Excludes
- M51.16 (Intervertebral disc disorders with radiculopathy, lumbar region)
Clinical Validation Requirements
- Imaging evidence of spondylosis and nerve root compression
- Neurological deficits such as dermatomal sensory loss or myotomal weakness
Code-Specific Risks
- Incorrectly using M54.16 when spondylosis is present
Coding Notes
- Ensure documentation explicitly links radiculopathy to spondylosis.
M51.16 - Intervertebral disc disorders with radiculopathy, lumbar region
Use when radiculopathy is caused by a herniated disc.
Applicable To
- Radiculopathy due to herniated disc
Excludes
- M47.27 (Other spondylosis with radiculopathy, lumbosacral region)
Clinical Validation Requirements
- Imaging showing disc herniation
- Radicular symptoms correlating to herniation level
Coding Notes
Ensure herniated disc is documented as the cause of radiculopathy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Radiculopathy, lumbar region
M54.16Differential 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 Lumbar Spondylosis with Radiculopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M47.27.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Potential for audit issues., Financial: Possible denial of claims.
Mitigation Strategy
Ensure detailed documentation of imaging and exam findings, Link symptoms to specific diagnoses
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation links radiculopathy to spondylosis.
Impact
Using M54.16 instead of M47.27 when spondylosis is present.
Mitigation Strategy
Educate staff on proper code selection and documentation requirements.
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 Spondylosis with Radiculopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumbar Spondylosis with Radiculopathy
Use these documentation templates to ensure complete and accurate documentation for Lumbar Spondylosis with Radiculopathy. These templates include all required elements for proper coding and billing.
Chronic lumbar spondylosis with radiculopathy
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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