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v1.0.0
ICD-10 Guide
ICD-10 CodesM43.5

M43.5

Billable

Other recurrent vertebral dislocation

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

Code Description

ICD-10 M43.5 is a billable code used to indicate a diagnosis of other recurrent vertebral dislocation.

Key Diagnostic Point:

Recurrent vertebral dislocation refers to the repeated displacement of vertebrae in the spinal column, which can lead to significant spinal deformities and functional impairments. This condition may arise from various underlying causes, including trauma, degenerative diseases, or congenital anomalies. Patients may present with symptoms such as back pain, neurological deficits, and postural abnormalities. The condition can contribute to spinal deformities like scoliosis, kyphosis, and lordosis, which may necessitate surgical interventions such as spinal fusion to stabilize the affected vertebrae. Accurate diagnosis and management are crucial to prevent further complications, including chronic pain and disability. Treatment often involves a multidisciplinary approach, including physical therapy, pain management, and surgical options, depending on the severity and underlying cause of the dislocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to recurrent dislocation
  • Potential for associated spinal deformities complicating diagnosis
  • Need for detailed documentation of clinical findings and treatment plans
  • Variability in treatment approaches among specialties

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to specify associated spinal deformities
  • Lack of clarity in treatment rationale
  • Misuse of related codes leading to incorrect billing

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed surgical notes, imaging studies, and pre/post-operative assessments.

Common Clinical Scenarios

Patients undergoing spinal fusion due to recurrent dislocation and associated deformities.

Billing Considerations

Ensure clear documentation of the surgical approach and rationale for fusion.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress.

Common Clinical Scenarios

Management of patients with recurrent dislocation and associated pain or disability.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M43.5 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the recurrent nature of the dislocation and any associated conditions
  • Include details on the specific vertebrae involved and any relevant imaging findings

Exclusion Criteria

Do NOT use M43.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior or posterolateral technique

Clinical Scenario

Used in cases of recurrent vertebral dislocation requiring stabilization.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for fusion in the context of recurrent dislocation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of recurrent vertebral dislocation, improving the accuracy of data collection and reimbursement processes. This specificity aids in better understanding the prevalence and treatment outcomes of this condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of recurrent vertebral dislocation, improving the accuracy of data collection and reimbursement processes. This specificity aids in better understanding the prevalence and treatment outcomes of this condition.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better understanding the prevalence and treatment outcomes of this condition.

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 causes of recurrent vertebral dislocation?

Common causes include trauma, degenerative diseases, congenital anomalies, and conditions leading to ligamentous laxity.

How is recurrent vertebral dislocation diagnosed?

Diagnosis typically involves a combination of clinical evaluation, patient history, and imaging studies such as X-rays or MRI.