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ICD-10 Guide
ICD-10 CodesM47.8

M47.8

Billable

Other spondylosis

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

Code Description

ICD-10 M47.8 is a billable code used to indicate a diagnosis of other spondylosis.

Key Diagnostic Point:

Other spondylosis (M47.8) refers to a group of degenerative spinal conditions that do not fall under the more specific categories of spondylosis, such as cervical or lumbar spondylosis. Spondylosis is characterized by the degeneration of the intervertebral discs and the vertebrae, leading to pain, stiffness, and reduced mobility. This condition can manifest in various forms, including osteophyte formation, disc herniation, and spinal stenosis. It is often associated with aging and can be exacerbated by factors such as obesity, sedentary lifestyle, and previous spinal injuries. Patients may experience symptoms ranging from localized back pain to radicular pain due to nerve root compression. Inflammatory spine conditions, such as ankylosing spondylitis, may also be considered under this umbrella, although they have distinct pathophysiological mechanisms. Accurate diagnosis and differentiation from other spinal disorders are crucial for effective management and treatment. The clinical presentation can vary widely, necessitating thorough evaluation and imaging studies to determine the underlying cause of symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions that can be classified as 'other spondylosis'
  • Need for precise documentation to differentiate from similar codes
  • Potential overlap with inflammatory spine conditions
  • Variability in clinical presentation and symptomatology

Audit Risk Factors

  • Inadequate documentation of the specific type of spondylosis
  • Failure to differentiate from inflammatory conditions
  • Misuse of the code in the absence of imaging confirmation
  • Inconsistent clinical findings reported in the medical record

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on physical examination findings, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all relevant imaging studies are included in the documentation to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive history of symptoms, laboratory tests for inflammatory markers, and imaging studies.

Common Clinical Scenarios

Patients with suspected ankylosing spondylitis or other inflammatory spine conditions.

Billing Considerations

Documentation should clearly differentiate between degenerative and inflammatory conditions to avoid coding errors.

Coding Guidelines

Inclusion Criteria

Use M47.8 When
  • According to ICD
  • 10 coding guidelines, M47
  • 8 should be used when the specific type of spondylosis is not documented
  • Coders must ensure that the diagnosis is supported by clinical findings and imaging results
  • It is important to note that this code should not be used if a more specific spondylosis code is applicable

Exclusion Criteria

Do NOT use M47.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

72040CPT Code

X-ray of the spine

Clinical Scenario

Used to evaluate degenerative changes in the spine.

Documentation Requirements

Radiology report must be included in the medical record.

Specialty Considerations

Orthopedic specialists often order these studies for diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of diagnoses and treatment plans. M47.8 provides a necessary option for cases that do not fit into more defined categories, but it requires careful documentation to avoid misclassification.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of diagnoses and treatment plans. M47.8 provides a necessary option for cases that do not fit into more defined categories, but it requires careful documentation to avoid misclassification.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of diagnoses and treatment plans. M47.8 provides a necessary option for cases that do not fit into more defined categories, but it requires careful documentation to avoid misclassification.

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 M47.8?

M47.8 encompasses various forms of spondylosis that do not fall under more specific categories, including degenerative changes in the spine that may not be clearly defined.

How can I differentiate M47.8 from other spondylosis codes?

To differentiate M47.8 from other codes, ensure that the documentation specifies that the spondylosis is not cervical or lumbar, and that it is supported by imaging findings.