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ICD-10 Guide
ICD-10 CodesM42.14

M42.14

Billable

Adult osteochondrosis of spine, thoracic region

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

Code Description

ICD-10 M42.14 is a billable code used to indicate a diagnosis of adult osteochondrosis of spine, thoracic region.

Key Diagnostic Point:

Adult osteochondrosis of the thoracic spine is a degenerative condition characterized by the deterioration of the intervertebral discs and vertebral bodies, leading to pain, stiffness, and potential deformities. This condition often manifests in individuals over the age of 18 and can result from a combination of genetic predisposition, mechanical stress, and age-related changes. Patients may present with symptoms such as localized thoracic pain, reduced range of motion, and in some cases, neurological deficits due to nerve root compression. The thoracic region is particularly susceptible to deformities such as kyphosis, which is an exaggerated forward curvature of the spine, and scoliosis, which is a lateral curvature. These deformities can further complicate the clinical picture, leading to additional challenges in treatment and management. Spinal fusion procedures may be indicated in severe cases to stabilize the spine and alleviate pain, particularly when conservative treatments have failed. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of spinal deformities
  • Understanding the relationship between osteochondrosis and other spinal conditions
  • Identifying the specific thoracic region affected
  • Documenting the severity and impact on function

Audit Risk Factors

  • Inadequate documentation of symptoms and functional limitations
  • Failure to specify the affected thoracic vertebrae
  • Misclassification of the condition as a primary diagnosis when it is secondary
  • Lack of evidence for conservative treatment prior to surgical intervention

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and pre-operative assessments are essential.

Common Clinical Scenarios

Patients presenting with chronic thoracic pain and deformities requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the surgical approach and any complications.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations of functional status and treatment plans.

Common Clinical Scenarios

Patients undergoing rehabilitation post-surgery or those with chronic pain management needs.

Billing Considerations

Documenting the impact of osteochondrosis on daily activities and rehabilitation goals.

Coding Guidelines

Inclusion Criteria

Use M42.14 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated deformities
  • Include any relevant imaging studies and treatment plans to support the diagnosis

Exclusion Criteria

Do NOT use M42.14 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 thoracic osteochondrosis with deformity requiring stabilization.

Documentation Requirements

Operative report detailing the procedure, indications, and any complications.

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 osteochondrosis, improving the accuracy of diagnoses and treatment plans. M42.14 provides a clear distinction from other spinal conditions, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteochondrosis, improving the accuracy of diagnoses and treatment plans. M42.14 provides a clear distinction from other spinal conditions, facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteochondrosis, improving the accuracy of diagnoses and treatment plans. M42.14 provides a clear distinction from other spinal conditions, facilitating better patient management.

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 M42.14?

Common symptoms include thoracic pain, stiffness, and potential deformities such as kyphosis or scoliosis.

How is M42.14 diagnosed?

Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and assessment of functional limitations.

What treatments are available for M42.14?

Treatment options may include physical therapy, pain management, and in severe cases, surgical interventions such as spinal fusion.