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v1.0.0
ICD-10 Guide
ICD-10 CodesM47.20

M47.20

Billable

Other spondylosis with radiculopathy, site unspecified

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

Code Description

ICD-10 M47.20 is a billable code used to indicate a diagnosis of other spondylosis with radiculopathy, site unspecified.

Key Diagnostic Point:

M47.20 refers to a condition characterized by degenerative changes in the spine, specifically spondylosis, which is associated with radiculopathy. Radiculopathy occurs when nerve roots are compressed or irritated, leading to symptoms such as pain, numbness, or weakness that radiate along the path of the affected nerve. This code is used when the specific site of the spondylosis is not specified, making it essential for coders to ensure that documentation supports the diagnosis. Spondylosis can arise from various factors, including aging, wear and tear, and inflammatory conditions. It is important to differentiate this condition from ankylosing spondylitis, which is a specific type of inflammatory arthritis affecting the spine. The presence of spinal stenosis, which is the narrowing of the spinal canal, can also contribute to radiculopathy and may coexist with spondylosis. Accurate coding requires a thorough understanding of the patient's clinical presentation and the underlying pathology, as well as the ability to interpret diagnostic imaging and clinical notes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified site can lead to ambiguity in documentation.
  • Differentiating between types of spondylosis and related conditions.
  • Need for comprehensive clinical documentation to support radiculopathy.
  • Potential overlap with other codes for spinal conditions.

Audit Risk Factors

  • Insufficient documentation of radiculopathy symptoms.
  • Lack of specificity regarding the site of spondylosis.
  • Inconsistent terminology used in clinical notes.
  • Failure to document the relationship between spondylosis and radiculopathy.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed clinical notes including physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic back pain, radicular symptoms, or post-surgical follow-ups.

Billing Considerations

Ensure that the documentation clearly states the relationship between spondylosis and radiculopathy.

Neurology

Documentation Requirements

Neurological assessments, imaging studies, and detailed descriptions of radiculopathy symptoms.

Common Clinical Scenarios

Patients with neurological deficits, pain radiating to extremities, or those undergoing nerve conduction studies.

Billing Considerations

Document the neurological examination findings and correlate them with imaging results.

Coding Guidelines

Inclusion Criteria

Use M47.20 When
  • According to ICD
  • CM guidelines, M47
  • 20 should be used when the documentation supports a diagnosis of spondylosis with radiculopathy without a specified site
  • Coders must ensure that the clinical documentation is comprehensive and reflects the patient's condition accurately

Exclusion Criteria

Do NOT use M47.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

722.0CPT Code

MRI of the spine

Clinical Scenario

Used to evaluate the extent of spondylosis and radiculopathy.

Documentation Requirements

MRI reports must clearly indicate findings related to spondylosis and radiculopathy.

Specialty Considerations

Orthopedic and neurology specialties should ensure imaging correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding spinal conditions, which aids in better tracking of patient outcomes and resource allocation. M47.20 reflects the need for coders to be diligent in documentation to avoid ambiguity.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding spinal conditions, which aids in better tracking of patient outcomes and resource allocation. M47.20 reflects the need for coders to be diligent in documentation to avoid ambiguity.

Reimbursement & Billing Impact

reimbursement.

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 documentation is needed to support the use of M47.20?

Documentation should include a clear diagnosis of spondylosis with radiculopathy, details of the patient's symptoms, results from imaging studies, and any relevant treatment plans.