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ICD-10 Guide
ICD-10 CodesM42.09

M42.09

Billable

Juvenile osteochondrosis of spine, multiple sites in spine

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

Code Description

ICD-10 M42.09 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, multiple sites in spine.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, particularly at multiple sites, is a condition characterized by the degeneration of the vertebral growth plates in children and adolescents. This condition can lead to spinal deformities such as scoliosis, kyphosis, and lordosis due to abnormal growth patterns and mechanical stress on the spine. The condition often manifests as pain, stiffness, and reduced mobility, which can significantly impact a child's quality of life. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and assessment of spinal alignment and function. Treatment may include physical therapy, bracing, or surgical interventions like spinal fusion, particularly in cases where conservative management fails or severe deformities develop. Understanding the complexities of this condition is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for detailed documentation of multiple sites affected
  • Differentiation from other spinal conditions
  • Potential for associated deformities requiring additional codes

Audit Risk Factors

  • Inadequate documentation of multiple sites affected
  • Failure to document associated spinal deformities
  • Misclassification of the condition as a non-juvenile osteochondrosis
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes, imaging reports, and treatment plans must be documented to support the diagnosis and any surgical interventions.

Common Clinical Scenarios

Orthopedic specialists often encounter cases of juvenile osteochondrosis presenting with back pain, deformities, or complications from previous treatments.

Billing Considerations

Orthopedic documentation should clearly outline the extent of the condition, any surgical interventions planned, and the expected outcomes.

Pediatrics

Documentation Requirements

Pediatricians should document growth patterns, developmental milestones, and any referrals to specialists for further evaluation.

Common Clinical Scenarios

Pediatricians frequently see children with back pain or postural abnormalities that may indicate underlying osteochondrosis.

Billing Considerations

Documentation should include a thorough history and physical examination, noting any family history of spinal disorders.

Coding Guidelines

Inclusion Criteria

Use M42.09 When
  • According to ICD
  • 10 coding guidelines, M42
  • 09 should be used when multiple sites of juvenile osteochondrosis are documented
  • It is essential to ensure that the diagnosis is confirmed through clinical evaluation and imaging studies

Exclusion Criteria

Do NOT use M42.09 When
  • Exclusion criteria include conditions that do not meet the definition of osteochondrosis

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in cases where juvenile osteochondrosis leads to significant spinal deformity requiring surgical correction.

Documentation Requirements

Operative reports must detail the procedure, indications, and any complications.

Specialty Considerations

Orthopedic surgeons should ensure that pre-operative evaluations and imaging are thoroughly documented.

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 diagnosis and treatment tracking. This specificity aids in better patient management 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 diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 back pain, stiffness, and visible spinal deformities such as scoliosis or kyphosis. Patients may also experience reduced mobility and discomfort during physical activities.