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ICD-10 Coding for Thoracic Radiculopathy(M54.14, M51.14)

Complete ICD-10-CM coding and documentation guide for Thoracic Radiculopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Thoracic Nerve Root CompressionThoracic Nerve Pain

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Related ICD-10 Code Ranges

Complete code families applicable to Thoracic Radiculopathy

M50-M54Primary Range

Other dorsopathies

This range includes codes for radiculopathy and disc disorders affecting the thoracic region.

G89

Pain, not elsewhere classified

Used for coding pain management encounters related to thoracic radiculopathy.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M54.14Radiculopathy, thoracic regionUse when thoracic radiculopathy is idiopathic or non-specific.
  • Neuro exam findings such as diminished reflexes, dermatome changes
  • Imaging not required if clinical findings are sufficient
M51.14Intervertebral disc disorders with radiculopathy, thoracic regionUse when radiculopathy is due to a confirmed disc disorder.
  • MRI showing disc herniation or nerve root compression

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 thoracic radiculopathy

Essential facts and insights about Thoracic Radiculopathy

The ICD-10 code for thoracic radiculopathy is M54.14 for idiopathic cases and M51.14 for disc-related cases.

Primary ICD-10-CM Codes for thoracic radiculopathy

M54.14
Radiculopathy, thoracic region
Billable Code

Decision Criteria

clinical Criteria

  • Presence of thoracic radicular pain without disc pathology

coding Criteria

  • No imaging required if clinical findings are sufficient

Applicable To

  • Thoracic radiculopathy without specific etiology

Excludes

  • Radiculopathy due to disc disorder (M51.14)

Clinical Validation Requirements

  • Neuro exam findings such as diminished reflexes, dermatome changes
  • Imaging not required if clinical findings are sufficient

Code-Specific Risks

  • Incorrectly using when disc etiology is present

Coding Notes

  • Ensure documentation specifies thoracic region and excludes disc-related causes.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Other chronic pain

G89.29
Use for pain management encounters related to thoracic radiculopathy.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Intervertebral disc disorders with radiculopathy, thoracic region

M51.14
Use when MRI confirms disc herniation causing radiculopathy.

Radiculopathy, thoracic region

M54.14
Use when no disc pathology is identified.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Thoracic Radiculopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.14.

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.

Mitigation Strategy

Ensure documentation includes specific neurological findings and imaging results.

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Use M51.14 when MRI confirms disc pathology.

Impact

Failure to sequence G89.29 first in pain management encounters.

Mitigation Strategy

Review documentation to confirm the primary reason for the encounter and sequence codes accordingly.

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 Thoracic Radiculopathy, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Thoracic Radiculopathy

Use these documentation templates to ensure complete and accurate documentation for Thoracic Radiculopathy. These templates include all required elements for proper coding and billing.

Physical Therapy Evaluation

Specialty: Physical Therapy

Required Elements

  • Pain Quality
  • Aggravating Factors
  • Neurological Exam
  • Special Tests

Example Documentation

[ ] Pain Quality: □ Burning □ Electric-like □ Band-like [ ] Aggravating Factors: □ Rotation □ Extension □ Deep inspiration [ ] Neurological Exam: □ Sensory: Decreased light touch ______ dermatome(s) □ Motor: ______% strength deficit in ______ muscle group □ Reflexes: □ Normal □ Diminished □ Absent at ______ level [ ] Special Tests: □ Slump test: □ Negative □ Positive at ______ level □ Valsalva: □ Negative □ Reproduced symptoms

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has mid-back pain
Good Documentation Example
T7 radicular pain (7/10 VAS) exacerbated by right rotation, with diminished pinprick sensation in T7 dermatome and 4/5 strength in lower intercostals
Explanation
The good example provides specific details about the pain, its location, and associated neurological findings, which are essential for accurate coding.

Need help with ICD-10 coding for Thoracic Radiculopathy? Ask your questions below.

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