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v1.0.0
ICD-10 Guide
ICD-10 CodesM46.8

M46.8

Billable

Other specified inflammatory spondylopathies

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

Code Description

ICD-10 M46.8 is a billable code used to indicate a diagnosis of other specified inflammatory spondylopathies.

Key Diagnostic Point:

M46.8 refers to a category of inflammatory spondylopathies that do not fall under more specific classifications such as ankylosing spondylitis or other well-defined inflammatory spinal conditions. Inflammatory spondylopathies are characterized by inflammation of the vertebrae and surrounding structures, leading to pain, stiffness, and potential mobility issues. These conditions can arise from various etiologies, including autoimmune disorders, infections, or post-traumatic inflammation. Patients may present with symptoms such as chronic back pain, reduced spinal mobility, and systemic manifestations like fatigue or fever. Diagnosis typically involves a combination of clinical evaluation, imaging studies (such as MRI or CT scans), and laboratory tests to identify inflammatory markers. Treatment often includes anti-inflammatory medications, physical therapy, and in some cases, surgical intervention to relieve symptoms or correct structural abnormalities. Understanding the nuances of M46.8 is crucial for accurate coding and ensuring appropriate reimbursement for the management of these complex conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to similar symptoms
  • Need for comprehensive documentation to support diagnosis
  • Differentiation from other inflammatory and non-inflammatory spine conditions
  • Potential overlap with other ICD-10 codes

Audit Risk Factors

  • Insufficient documentation to support the diagnosis
  • Inconsistent use of related codes
  • Lack of clarity in clinical notes regarding the inflammatory nature of the condition
  • Failure to document the patient's response to treatment

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical history, physical examination findings, imaging results, and laboratory tests indicating inflammation.

Common Clinical Scenarios

Patients presenting with chronic back pain, stiffness, and systemic symptoms suggestive of inflammatory spondylopathy.

Billing Considerations

Rheumatologists must ensure that all relevant diagnostic criteria are documented to support the use of M46.8.

Orthopedics

Documentation Requirements

Surgical notes, imaging studies, and pre-operative assessments that detail the inflammatory nature of the spine condition.

Common Clinical Scenarios

Patients requiring surgical intervention for spinal stenosis or other complications arising from inflammatory spondylopathies.

Billing Considerations

Orthopedic surgeons should document the relationship between the inflammatory condition and any structural changes in the spine.

Coding Guidelines

Inclusion Criteria

Use M46.8 When
  • According to ICD
  • 10 guidelines, M46
  • 8 should be used when the specific inflammatory spondylopathy is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that the condition is not better described by a more specific code

Exclusion Criteria

Do NOT use M46.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

72148CPT Code

MRI of the spine

Clinical Scenario

When imaging is performed to evaluate inflammatory changes in the spine.

Documentation Requirements

MRI reports must clearly indicate findings consistent with inflammatory spondylopathy.

Specialty Considerations

Rheumatologists and orthopedic surgeons should ensure imaging studies are linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of inflammatory spondylopathies, improving the granularity of data for research and treatment outcomes. M46.8 provides a necessary option for conditions that do not fit neatly into other categories.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of inflammatory spondylopathies, improving the granularity of data for research and treatment outcomes. M46.8 provides a necessary option for conditions that do not fit neatly into other categories.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of inflammatory spondylopathies, improving the granularity of data for research and treatment outcomes. M46.8 provides a necessary option for conditions that do not fit neatly into other categories.

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 conditions are included under M46.8?

M46.8 includes various inflammatory spondylopathies that do not have a more specific classification, such as those resulting from autoimmune diseases or infections.

How do I differentiate M46.8 from M45?

M45 is specifically for ankylosing spondylitis, while M46.8 is used for other inflammatory spondylopathies that do not fit the criteria for ankylosing spondylitis.