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v1.0.0
ICD-10 Guide
ICD-10 CodesM47.897

M47.897

Billable

Other spondylosis, lumbosacral region

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

Code Description

ICD-10 M47.897 is a billable code used to indicate a diagnosis of other spondylosis, lumbosacral region.

Key Diagnostic Point:

M47.897 refers to other forms of spondylosis affecting the lumbosacral region, which encompasses the lower back and sacral area of the spine. Spondylosis is a degenerative condition characterized by the wear and tear of the spinal discs and joints, leading to pain, stiffness, and reduced mobility. In the lumbosacral region, this condition can manifest as chronic lower back pain, which may radiate to the legs due to nerve compression. The term 'other spondylosis' indicates that the specific type of spondylosis does not fall under more defined categories such as ankylosing spondylitis or degenerative disc disease. Patients may experience symptoms related to spinal stenosis, where the spinal canal narrows and compresses the spinal cord or nerves, leading to further complications. Inflammatory spine conditions may also be present, contributing to pain and functional limitations. Accurate diagnosis often requires imaging studies, such as MRI or CT scans, to assess the extent of degeneration and rule out other conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of spondylosis types that may be misclassified
  • Overlap with other spinal conditions like spinal stenosis
  • Need for precise documentation of symptoms and imaging findings
  • Potential for co-existing inflammatory conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of spondylosis
  • Misalignment between diagnosis and treatment provided
  • Inconsistent use of imaging results in documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic lower back pain, radiculopathy, or post-surgical follow-ups.

Billing Considerations

Ensure that all relevant imaging studies are documented and correlate with the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and patient history related to autoimmune conditions.

Common Clinical Scenarios

Patients with suspected ankylosing spondylitis or other inflammatory spine diseases.

Billing Considerations

Document any inflammatory symptoms and laboratory results to differentiate from degenerative conditions.

Coding Guidelines

Inclusion Criteria

Use M47.897 When
  • According to ICD
  • 10 coding guidelines, M47
  • 897 should be used when the specific type of spondylosis is not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and that the condition is not better described by a more specific code

Exclusion Criteria

Do NOT use M47.897 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

72040CPT Code

Radiologic examination, spine, lumbosacral, standing

Clinical Scenario

Used to evaluate the extent of spondylosis in the lumbosacral region.

Documentation Requirements

Radiology report must be included in the patient's medical record.

Specialty Considerations

Orthopedic specialists should correlate imaging findings with clinical symptoms.

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 ability to capture the nuances of spinal conditions. M47.897 provides a distinct code for cases that do not fit neatly into other categories, enhancing data accuracy and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the ability to capture the nuances of spinal conditions. M47.897 provides a distinct code for cases that do not fit neatly into other categories, enhancing data accuracy and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the ability to capture the nuances of spinal conditions. M47.897 provides a distinct code for cases that do not fit neatly into other categories, enhancing data accuracy and treatment planning.

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 is the difference between M47.897 and M47.1?

M47.897 is used for other types of spondylosis in the lumbosacral region that do not fit the criteria for cervical spondylosis (M47.1). Accurate documentation is essential to differentiate between these conditions.