ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM41.5

M41.5

Billable

Other secondary scoliosis

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

Code Description

ICD-10 M41.5 is a billable code used to indicate a diagnosis of other secondary scoliosis.

Key Diagnostic Point:

Other secondary scoliosis refers to a curvature of the spine that is not classified as idiopathic and arises due to other underlying conditions. This type of scoliosis can be associated with various factors, including neuromuscular disorders, congenital anomalies, or degenerative diseases. Unlike idiopathic scoliosis, which typically occurs in adolescents without a known cause, secondary scoliosis is often a result of conditions such as cerebral palsy, muscular dystrophy, or spinal injuries. The curvature can lead to significant postural changes, pain, and functional limitations. Diagnosis is typically made through physical examination and imaging studies, such as X-rays, which reveal the degree and pattern of curvature. Treatment options may vary based on the severity of the curvature and the underlying condition, ranging from physical therapy and bracing to surgical interventions like spinal fusion. Understanding the etiology of the scoliosis is crucial for effective management and coding, as it influences the treatment approach and potential complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions leading to secondary scoliosis
  • Need for precise documentation of the primary condition
  • Differentiation from idiopathic scoliosis
  • Potential for multiple comorbidities

Audit Risk Factors

  • Inadequate documentation of the underlying condition
  • Failure to specify the type of scoliosis
  • Misclassification as idiopathic scoliosis
  • Lack of supporting imaging studies

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of the patient's condition, imaging results, and treatment plans.

Common Clinical Scenarios

Patients with scoliosis due to neuromuscular disorders or post-surgical changes.

Billing Considerations

Ensure accurate documentation of the curvature's degree and any associated symptoms.

Neurology

Documentation Requirements

Comprehensive neurological assessment and documentation of any related neurological deficits.

Common Clinical Scenarios

Patients with scoliosis secondary to conditions like cerebral palsy or spinal cord injuries.

Billing Considerations

Document the neurological condition's impact on scoliosis development.

Coding Guidelines

Inclusion Criteria

Use M41.5 When
  • According to ICD
  • 10 guidelines, M41
  • 5 should be used when scoliosis is secondary to another condition
  • Coders must ensure that the primary condition is documented and coded appropriately

Exclusion Criteria

Do NOT use M41.5 When
  • Exclusion criteria include idiopathic scoliosis and other specific types of scoliosis that do not fall under secondary classifications

Related ICD-10 Codes

Related CPT Codes

22558CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used for surgical correction of severe secondary scoliosis.

Documentation Requirements

Pre-operative assessments, imaging studies, and surgical notes.

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, including secondary scoliosis, which enhances the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of scoliosis types, including secondary scoliosis, which enhances the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

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 is the difference between idiopathic and secondary scoliosis?

Idiopathic scoliosis occurs without a known cause, typically in adolescents, while secondary scoliosis arises from underlying conditions such as neuromuscular disorders or congenital anomalies.