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ICD-10 Guide
ICD-10 CodesM43.14

M43.14

Billable

Spondylolisthesis, thoracic region

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

Code Description

ICD-10 M43.14 is a billable code used to indicate a diagnosis of spondylolisthesis, thoracic region.

Key Diagnostic Point:

Spondylolisthesis is a condition characterized by the displacement of one vertebra over another, which can lead to spinal instability and pain. In the thoracic region, this condition is less common than in the lumbar region but can still significantly impact a patient's quality of life. The thoracic spine consists of twelve vertebrae, and spondylolisthesis in this area can result from various factors, including congenital defects, degenerative changes, trauma, or pathological conditions. Symptoms may include localized pain, stiffness, and in some cases, neurological deficits if nerve roots are compressed. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess the degree of slippage and any associated spinal deformities. Treatment options may range from conservative management, including physical therapy and pain management, to surgical interventions like spinal fusion, which aims to stabilize the affected vertebrae and restore spinal alignment. Understanding the nuances of spondylolisthesis in the thoracic region is crucial for accurate coding and effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Differentiation from other spinal deformities like scoliosis and kyphosis
  • Need for precise imaging documentation to support diagnosis
  • Potential for co-existing conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of imaging studies
  • Failure to specify the degree of vertebral slippage
  • Misidentification of the affected spinal region
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and pre/post-operative assessments are essential.

Common Clinical Scenarios

Patients presenting with back pain, neurological symptoms, or those requiring surgical intervention for stabilization.

Billing Considerations

Ensure that the surgical approach and any fusion techniques used are clearly documented.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes are necessary to support ongoing management.

Common Clinical Scenarios

Patients undergoing conservative management for pain relief and functional improvement.

Billing Considerations

Documenting the patient's response to therapy and any changes in functional status is critical.

Coding Guidelines

Inclusion Criteria

Use M43.14 When
  • According to ICD
  • 10 coding guidelines, M43
  • 14 should be used when spondylolisthesis is specifically diagnosed in the thoracic region
  • Coders must ensure that the diagnosis is supported by appropriate clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M43.14 When
  • Exclusion criteria include conditions that do not involve vertebral slippage

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in surgical management of thoracic spondylolisthesis.

Documentation Requirements

Operative report detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons must document the specific vertebrae involved and the technique used.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylolisthesis, 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 spondylolisthesis, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance.

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 is the primary cause of spondylolisthesis in the thoracic region?

The primary causes include congenital defects, degenerative changes due to aging, trauma, and certain pathological conditions. Each case may vary based on individual patient factors.