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ICD-10 Guide
ICD-10 CodesM42.06

M42.06

Billable

Juvenile osteochondrosis of spine, lumbar region

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

Code Description

ICD-10 M42.06 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, lumbar region.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, particularly in the lumbar region, is a condition characterized by the degeneration of the intervertebral discs and vertebral bodies in children and adolescents. This condition often arises during periods of rapid growth and can lead to significant spinal deformities such as scoliosis, kyphosis, and lordosis. The lumbar region is particularly vulnerable due to its weight-bearing function and mobility. Symptoms may include back pain, stiffness, and in some cases, neurological deficits due to nerve root compression. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and assessment of the patient's growth patterns. Treatment may range from conservative management, including physical therapy and bracing, to surgical interventions like spinal fusion in severe cases. Understanding the implications of juvenile osteochondrosis is crucial for effective management and prevention of long-term complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms among patients
  • Need for precise documentation of growth patterns
  • Differentiation from other spinal deformities
  • Potential for co-existing conditions affecting treatment

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the lumbar region in coding
  • Misclassification with adult osteochondrosis codes
  • Lack of imaging documentation to support diagnosis

Specialty Focus

Medical Specialties

Pediatric Orthopedics

Documentation Requirements

Detailed growth history, imaging results, and treatment plans.

Common Clinical Scenarios

Management of adolescent patients with back pain and suspected osteochondrosis.

Billing Considerations

Consideration of growth spurts and their impact on treatment decisions.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, therapy progress notes, and patient-reported outcomes.

Common Clinical Scenarios

Rehabilitation following surgical intervention for severe osteochondrosis.

Billing Considerations

Focus on functional improvement and pain management strategies.

Coding Guidelines

Inclusion Criteria

Use M42.06 When
  • According to ICD
  • 10 coding guidelines, M42
  • 06 should be used when the diagnosis of juvenile osteochondrosis is confirmed through clinical evaluation and imaging
  • It is essential to document the specific lumbar region affected and any associated symptoms or complications

Exclusion Criteria

Do NOT use M42.06 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, lumbar

Clinical Scenario

Used in cases of severe juvenile osteochondrosis requiring surgical intervention.

Documentation Requirements

Pre-operative assessments, surgical notes, and post-operative care documentation.

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 juvenile osteochondrosis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of juvenile osteochondrosis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 are the common symptoms of juvenile osteochondrosis?

Common symptoms include lower back pain, stiffness, and potential neurological symptoms due to nerve compression. Patients may also exhibit postural changes such as scoliosis or kyphosis.