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v1.0.0
ICD-10 Guide
ICD-10 CodesM41.80

M41.80

Billable

Other forms of scoliosis, site unspecified

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

Code Description

ICD-10 M41.80 is a billable code used to indicate a diagnosis of other forms of scoliosis, site unspecified.

Key Diagnostic Point:

M41.80 refers to other forms of scoliosis that do not fall under the more specific categories of idiopathic, congenital, or neuromuscular scoliosis. Scoliosis is characterized by an abnormal lateral curvature of the spine, which can lead to various complications, including pain, reduced lung capacity, and impaired mobility. The condition can arise from a variety of causes, including muscular dystrophy, cerebral palsy, or other neuromuscular disorders. In many cases, the exact etiology remains unclear, leading to the classification as 'other forms.' Patients may present with varying degrees of curvature, and the condition can be progressive, necessitating careful monitoring and potential intervention. Treatment options may include physical therapy, bracing, or surgical interventions such as spinal fusion, depending on the severity and progression of the curvature. Accurate coding is essential for appropriate management and reimbursement, as well as for tracking the epidemiology of scoliosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to scoliosis.
  • Need for precise documentation of curvature and symptoms.
  • Differentiation from other types of scoliosis.
  • Potential for co-existing conditions affecting treatment.

Audit Risk Factors

  • Insufficient documentation of the underlying cause.
  • Inconsistent use of the code across different providers.
  • Failure to document the severity of the curvature.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes on curvature measurements, patient history, and treatment plans.

Common Clinical Scenarios

Patients presenting with back pain, abnormal posture, or findings on imaging studies.

Billing Considerations

Ensure that all imaging studies are documented and that the rationale for treatment decisions is clear.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for scoliosis-related pain or mobility issues.

Billing Considerations

Document the impact of scoliosis on daily activities and the effectiveness of therapeutic interventions.

Coding Guidelines

Inclusion Criteria

Use M41.80 When
  • According to ICD
  • 10 guidelines, M41
  • 80 should be used when the specific type of scoliosis is not documented
  • Coders must ensure that the documentation supports the diagnosis and that the condition is not better classified under more specific codes

Exclusion Criteria

Do NOT use M41.80 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in cases of severe scoliosis requiring surgical intervention.

Documentation Requirements

Operative report detailing the procedure, indications, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and expected outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of scoliosis, improving the ability to track and manage the condition. M41.80 serves as a catch-all for cases that do not fit into more defined categories, emphasizing the need for thorough documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of scoliosis, improving the ability to track and manage the condition. M41.80 serves as a catch-all for cases that do not fit into more defined categories, emphasizing the need for thorough documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of scoliosis, improving the ability to track and manage the condition. M41.80 serves as a catch-all for cases that do not fit into more defined categories, emphasizing the need for thorough documentation.

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

When should I use M41.80 instead of a more specific scoliosis code?

M41.80 should be used when the specific type of scoliosis is not documented or when the underlying cause is unclear. Always refer to the clinical documentation to determine the most accurate code.