ICD-10 Coding for Osteoarthritis of the Spine(M47.16, M47.26, M47.817)
Complete ICD-10-CM coding and documentation guide for Osteoarthritis of the Spine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Osteoarthritis of the Spine
M47Primary Range
Spondylosis
This range includes codes for spondylosis, which is the primary classification for osteoarthritis of the spine.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M47.16 | Lumbar spondylosis with myelopathy | Use when lumbar spondylosis is present with myelopathy confirmed by imaging. |
|
| M47.26 | Lumbar spondylosis with radiculopathy | Use when lumbar spondylosis is present with radiculopathy confirmed by EMG or imaging. |
|
| M47.817 | Lumbosacral spondylosis without myelopathy or radiculopathy | Use when spondylosis is present without neurological complications. |
|
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 osteoarthritis of the spine
Essential facts and insights about Osteoarthritis of the Spine
Primary ICD-10-CM Codes for osteoarthritis of spine
Decision Criteria
clinical Criteria
- Presence of myelopathy symptoms and imaging confirmation
Applicable To
- Lumbar spondylosis with spinal cord compression
Excludes
- Cervical spondylosis with myelopathy (M47.12)
Clinical Validation Requirements
- MRI showing spinal cord compression
- Neurological examination indicating myelopathy
Code-Specific Risks
- Misclassification if myelopathy is not documented
Coding Notes
- Ensure myelopathy is clearly documented with imaging support.
M47.26 - Lumbar spondylosis with radiculopathy
Use when lumbar spondylosis is present with radiculopathy confirmed by EMG or imaging.
Applicable To
- Lumbar spondylosis with nerve root compression
Excludes
- Cervical spondylosis with radiculopathy (M47.22)
Clinical Validation Requirements
- EMG showing radiculopathy
- MRI indicating nerve root compression
Coding Notes
Document radiculopathy with specific nerve root involvement.
M47.817 - Lumbosacral spondylosis without myelopathy or radiculopathy
Use when spondylosis is present without neurological complications.
Applicable To
- Degenerative joint disease of the lumbosacral spine
Excludes
- Spondylosis with myelopathy or radiculopathy
Clinical Validation Requirements
- X-ray showing osteophytes and joint space narrowing
Coding Notes
Ensure absence of myelopathy or radiculopathy is documented.
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.
Spinal stenosis, lumbar region
M48.06Intervertebral disc disorders with radiculopathy, lumbar region
M51.16Low back pain
M54.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Osteoarthritis of the Spine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M47.16.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential under-coding and reimbursement loss.
Mitigation Strategy
Thorough neurological examination and documentation., Use of imaging to confirm diagnoses.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the region and presence of complications.
Impact
Lack of detailed documentation for neurological symptoms can lead to audit flags.
Mitigation Strategy
Ensure comprehensive documentation of neurological exams and imaging.
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 Osteoarthritis of the Spine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Osteoarthritis of the Spine
Use these documentation templates to ensure complete and accurate documentation for Osteoarthritis of the Spine. 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
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Osteoarthritis of the Spine? Ask your questions below.