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v1.0.0
ICD-10 Guide
ICD-10 CodesM42.07

M42.07

Billable

Juvenile osteochondrosis of spine, lumbosacral region

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

Code Description

ICD-10 M42.07 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, lumbosacral region.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, specifically in the lumbosacral region, is a condition characterized by the degeneration of the vertebral endplates and adjacent disc material in growing children and adolescents. This condition often leads to pain, limited mobility, and potential spinal deformities such as scoliosis, kyphosis, or lordosis. The lumbosacral region is particularly vulnerable due to the biomechanical stresses placed on it during growth spurts. Symptoms may include localized back pain, stiffness, and in some cases, neurological symptoms if nerve roots are affected. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and a thorough assessment of the patient's history. Treatment options may vary from conservative management, including physical therapy and pain management, to surgical interventions like spinal fusion if significant deformities or instability are present. Early diagnosis and intervention are crucial to prevent long-term complications and to promote optimal spinal health as the child matures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among patients
  • Need for precise documentation of symptoms and imaging findings
  • Potential for co-existing spinal deformities
  • Differentiation from other spinal conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document co-existing conditions
  • Lack of imaging studies to support diagnosis
  • Improper coding of associated spinal deformities

Specialty Focus

Medical Specialties

Pediatric Orthopedics

Documentation Requirements

Detailed clinical notes including growth patterns, physical examination findings, and imaging results.

Common Clinical Scenarios

Management of adolescent patients presenting with back pain and suspected osteochondrosis.

Billing Considerations

Consideration of growth spurts and their impact on spinal health.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Rehabilitation following surgical intervention for spinal deformities.

Billing Considerations

Focus on long-term functional outcomes and pain management strategies.

Coding Guidelines

Inclusion Criteria

Use M42.07 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the diagnosis, associated conditions, and treatment plans
  • Include specific details about the location and severity of the osteochondrosis

Exclusion Criteria

Do NOT use M42.07 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, lumbar

Clinical Scenario

Used when surgical intervention is required for severe deformities.

Documentation Requirements

Operative reports detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery.

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.

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.

Reimbursement & Billing Impact

reimbursement processes.

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 localized back pain, stiffness, and potential neurological symptoms if nerve roots are affected. Patients may also exhibit signs of spinal deformities.