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ICD-10 Guide
ICD-10 CodesM43.18

M43.18

Billable

Spondylolisthesis, sacral and sacrococcygeal region

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M43.18 is a billable code used to indicate a diagnosis of spondylolisthesis, sacral and sacrococcygeal region.

Key Diagnostic Point:

Spondylolisthesis is a condition characterized by the displacement of one vertebra over another, which can lead to spinal instability and pain. In the sacral and sacrococcygeal region, this condition can result from congenital defects, degenerative changes, trauma, or pathological processes. Patients may present with lower back pain, radicular symptoms, or neurological deficits depending on the severity of the slippage and the involvement of adjacent structures. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess the degree of slippage and any associated spinal deformities. Treatment options may include conservative management with physical therapy and pain management, or surgical interventions such as spinal fusion to stabilize the affected vertebrae. The condition can also be associated with other spinal deformities such as scoliosis, kyphosis, and lordosis, which may complicate the clinical picture and influence treatment decisions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of symptoms
  • Need for precise imaging documentation
  • Differentiation from other spinal conditions
  • Potential for coexisting spinal deformities

Audit Risk Factors

  • Inadequate documentation of imaging findings
  • Failure to document conservative treatment attempts
  • Misclassification of the degree of spondylolisthesis
  • Lack of clarity on associated spinal deformities

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are essential.

Common Clinical Scenarios

Patients presenting with severe back pain and neurological symptoms requiring surgical intervention.

Billing Considerations

Documentation must clearly outline the rationale for surgical intervention and any associated spinal deformities.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations including functional assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing conservative management with physical therapy and pain management.

Billing Considerations

Documentation should reflect the patient's functional status and response to therapy.

Coding Guidelines

Inclusion Criteria

Use M43.18 When
  • According to ICD
  • 10 guidelines, M43
  • 18 should be used when the spondylolisthesis is specifically located in the sacral and sacrococcygeal region
  • Coders must ensure that the diagnosis is supported by imaging and clinical findings

Exclusion Criteria

Do NOT use M43.18 When
  • Exclusion criteria include conditions that do not involve displacement of vertebrae

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior or posterolateral technique

Clinical Scenario

Used in surgical treatment of spondylolisthesis to stabilize the spine.

Documentation Requirements

Operative report detailing the procedure and indication for surgery.

Specialty Considerations

Orthopedic surgeons must document the specific levels involved and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylolisthesis, improving the accuracy of data collection and reimbursement processes. M43.18 provides a clear distinction for cases involving the sacral and sacrococcygeal region, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylolisthesis, improving the accuracy of data collection and reimbursement processes. M43.18 provides a clear distinction for cases involving the sacral and sacrococcygeal region, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. M43.18 provides a clear distinction for cases involving the sacral and sacrococcygeal region, which was less defined in ICD-9.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What imaging studies are necessary for diagnosing M43.18?

Imaging studies such as X-rays, MRI, or CT scans are essential for diagnosing spondylolisthesis. These studies help assess the degree of vertebral slippage and any associated spinal deformities.