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ICD-10 Guide
ICD-10 CodesM42.12

M42.12

Billable

Adult osteochondrosis of spine, cervical region

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

Code Description

ICD-10 M42.12 is a billable code used to indicate a diagnosis of adult osteochondrosis of spine, cervical region.

Key Diagnostic Point:

Adult osteochondrosis of the cervical spine is a degenerative condition characterized by the deterioration of the intervertebral discs and vertebral bodies in the cervical region. This condition typically arises due to age-related changes, leading to disc herniation, osteophyte formation, and potential spinal stenosis. Patients may present with neck pain, stiffness, and neurological symptoms such as radiculopathy or myelopathy due to nerve root or spinal cord compression. The condition can also contribute to spinal deformities such as kyphosis or lordosis, which may further complicate the clinical picture. Diagnosis is often confirmed through imaging studies, including X-rays, MRI, or CT scans, which reveal disc degeneration and associated bony changes. Treatment options may include conservative management with physical therapy and pain management, or surgical interventions such as spinal fusion to stabilize the affected segments and alleviate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between osteochondrosis and other degenerative spine conditions.
  • Need for precise documentation of symptoms and imaging findings.
  • Potential for co-existing spinal deformities complicating the diagnosis.
  • Variability in treatment approaches based on severity and patient response.

Audit Risk Factors

  • Inadequate documentation of neurological symptoms.
  • Failure to document imaging studies that support the diagnosis.
  • Misclassification of the condition as a primary diagnosis when it is secondary.
  • Lack of clarity in treatment plans, especially regarding surgical interventions.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments.

Common Clinical Scenarios

Patients presenting with cervical radiculopathy or myelopathy requiring surgical intervention.

Billing Considerations

Ensure documentation reflects the severity of symptoms and the rationale for surgical procedures.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Patients undergoing conservative management for neck pain and functional limitations.

Billing Considerations

Documenting the effectiveness of non-surgical treatments and patient response to therapy.

Coding Guidelines

Inclusion Criteria

Use M42.12 When
  • According to the official coding guidelines, M42
  • 12 should be used when the condition is specifically diagnosed as osteochondrosis of the cervical spine
  • It is important to document any associated symptoms, imaging findings, and treatment plans to support the use of this code

Exclusion Criteria

Do NOT use M42.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used for patients with cervical osteochondrosis 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 conditions like M42.12, improving the accuracy of diagnoses 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 conditions like M42.12, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M42.12, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management 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 adult osteochondrosis of the cervical spine?

Common symptoms include neck pain, stiffness, and neurological symptoms such as numbness or weakness in the arms due to nerve root compression.

How is adult osteochondrosis of the cervical spine diagnosed?

Diagnosis typically involves a combination of clinical evaluation, patient history, and imaging studies such as X-rays or MRI to assess disc degeneration and bony changes.