ICD-10 Coding for Lumbosacral Spine Degenerative Conditions(M51.362, M51.371)
Complete ICD-10-CM coding and documentation guide for Lumbosacral Spine Degenerative Conditions. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumbosacral Spine Degenerative Conditions
M51.36-M51.37Primary Range
ICD-10 codes for lumbar and lumbosacral disc degeneration
These codes are used to classify degenerative disc conditions in the lumbar and lumbosacral regions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.362 | Other intervertebral disc degeneration, lumbar region with radiculopathy | Use when lumbar disc degeneration is confirmed with radiculopathy. |
|
| M51.371 | Other intervertebral disc degeneration, lumbosacral region with radiculopathy | Use when lumbosacral degeneration is confirmed with radiculopathy. |
|
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 lumbosacral disc degeneration
Essential facts and insights about Lumbosacral Spine Degenerative Conditions
Primary ICD-10-CM Codes for physician initials lumbosacral spine
Decision Criteria
clinical Criteria
- Presence of Modic changes and radiculopathy
Applicable To
- Discogenic back pain with leg pain
Excludes
- Radiculopathy NOS (M54.1)
Clinical Validation Requirements
- MRI showing Modic changes
- Concordant discography
- Pain radiating to bilateral thighs
Code-Specific Risks
- Misclassification if radiculopathy is not confirmed
Coding Notes
- Ensure documentation specifies discogenic origin of pain.
M51.371 - Other intervertebral disc degeneration, lumbosacral region with radiculopathy
Use when lumbosacral degeneration is confirmed with radiculopathy.
Applicable To
- Lumbosacral degeneration with isolated leg pain
Excludes
- Sciatica NOS (M54.3)
Clinical Validation Requirements
- Negative straight leg raise
- Positive femoral nerve tension test
- EMG-confirmed L5 radiculopathy
Coding Notes
Ensure documentation specifies discogenic origin of pain.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Lumbago with sciatica
M54.41Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lumbosacral Spine Degenerative Conditions to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.362.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Use specific terminology linking symptoms to imaging findings., Regular training on documentation standards.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use M51.362 when discogenic etiology is documented.
Impact
Risk of audits due to incorrect coding of lumbar and lumbosacral conditions.
Mitigation Strategy
Ensure thorough documentation and correct code selection.
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 Lumbosacral Spine Degenerative Conditions, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumbosacral Spine Degenerative Conditions
Use these documentation templates to ensure complete and accurate documentation for Lumbosacral Spine Degenerative Conditions. These templates include all required elements for proper coding and billing.
Chronic low back pain with radiculopathy
Specialty: NeurologyRequired 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
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