Spinal enthesopathy, cervicothoracic region
ICD-10 M46.03 is a billable code used to indicate a diagnosis of spinal enthesopathy, cervicothoracic region.
Spinal enthesopathy in the cervicothoracic region refers to a condition characterized by inflammation and degeneration at the sites where tendons and ligaments attach to the vertebrae in the neck and upper back. This condition can be associated with various inflammatory spine diseases, including ankylosing spondylitis, which is a type of spondyloarthritis that primarily affects the spine and the sacroiliac joints. Patients may present with chronic pain, stiffness, and reduced mobility in the cervicothoracic area. The condition can also be linked to spinal stenosis, where the spinal canal narrows, leading to nerve compression and further exacerbating symptoms. Diagnosis typically involves a combination of clinical evaluation, imaging studies such as MRI or X-rays, and laboratory tests to rule out other inflammatory conditions. Treatment may include physical therapy, anti-inflammatory medications, and in some cases, surgical intervention to relieve symptoms and improve function.
Detailed patient history, physical examination findings, imaging results, and treatment plans.
Patients with chronic neck pain, stiffness, and a history of inflammatory arthritis.
Ensure that the documentation clearly indicates the relationship between enthesopathy and any underlying inflammatory conditions.
Comprehensive assessment of spinal alignment, range of motion, and any surgical interventions performed.
Patients presenting with cervical radiculopathy or myelopathy due to enthesopathy.
Document any surgical procedures or interventions that may impact the coding.
Used to evaluate for enthesopathy in patients with neck pain.
Document the reason for the X-ray and findings.
Rheumatologists should correlate imaging findings with clinical symptoms.
Spinal enthesopathy is often associated with inflammatory conditions such as ankylosing spondylitis, which leads to inflammation at the attachment sites of tendons and ligaments.
