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ICD-10 Guide
ICD-10 CodesM41.127

M41.127

Billable

Adolescent idiopathic scoliosis, lumbosacral region

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

Code Description

ICD-10 M41.127 is a billable code used to indicate a diagnosis of adolescent idiopathic scoliosis, lumbosacral region.

Key Diagnostic Point:

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity characterized by lateral curvature of the spine, typically diagnosed in children and adolescents aged 10 to 18 years. The lumbosacral region refers specifically to the lower part of the spine, which includes the lumbar vertebrae and the sacrum. The etiology of AIS remains largely unknown, although genetic factors and biomechanical influences are believed to play a role. The condition can lead to significant physical deformities, functional limitations, and psychosocial issues if left untreated. Diagnosis is primarily based on clinical examination and radiographic evaluation, including Cobb angle measurement to assess the degree of curvature. Treatment options vary based on the severity of the curvature and the patient's age, ranging from observation and bracing to surgical intervention, such as spinal fusion, in more severe cases. Early detection and appropriate management are crucial to prevent progression and associated complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in curvature severity and progression
  • Need for precise measurement of Cobb angle
  • Differentiation from other types of scoliosis
  • Documentation of treatment plans and outcomes

Audit Risk Factors

  • Inadequate documentation of curvature measurements
  • Failure to specify the lumbosacral region
  • Lack of clarity on treatment plans
  • Misclassification of idiopathic versus non-idiopathic scoliosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, treatment plans, and follow-up assessments.

Common Clinical Scenarios

Surgical intervention for severe scoliosis, bracing recommendations, and monitoring of progression.

Billing Considerations

Ensure accurate documentation of Cobb angles and rationale for surgical decisions.

Pediatrics

Documentation Requirements

Growth charts, family history, and developmental assessments.

Common Clinical Scenarios

Routine screening for scoliosis during well-child visits and referrals for orthopedic evaluation.

Billing Considerations

Document any psychosocial impacts on the patient due to scoliosis.

Coding Guidelines

Inclusion Criteria

Use M41.127 When
  • Follow ICD
  • CM guidelines for coding spinal deformities
  • Ensure accurate documentation of the condition's severity and treatment
  • Include any relevant co
  • morbidities and specify the lumbosacral region

Exclusion Criteria

Do NOT use M41.127 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22610CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used for surgical correction of severe adolescent idiopathic scoliosis.

Documentation Requirements

Operative reports detailing the procedure and pre-operative assessments.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving data accuracy and treatment tracking. M41.127 provides specificity for adolescent idiopathic scoliosis, enhancing clinical understanding and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving data accuracy and treatment tracking. M41.127 provides specificity for adolescent idiopathic scoliosis, enhancing clinical understanding and management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving data accuracy and treatment tracking. M41.127 provides specificity for adolescent idiopathic scoliosis, enhancing clinical understanding and management.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Frequently Asked Questions

What is the significance of the Cobb angle in scoliosis?

The Cobb angle is a critical measurement used to assess the severity of scoliosis. It helps determine the need for treatment, including bracing or surgical intervention, and is essential for monitoring progression over time.