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v1.0.0
ICD-10 Guide
ICD-10 CodesM47.898

M47.898

Billable

Other spondylosis, sacral and sacrococcygeal region

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

Code Description

ICD-10 M47.898 is a billable code used to indicate a diagnosis of other spondylosis, sacral and sacrococcygeal region.

Key Diagnostic Point:

M47.898 refers to other forms of spondylosis affecting the sacral and sacrococcygeal regions of the spine. Spondylosis is a degenerative condition characterized by the wear and tear of spinal discs and vertebrae, leading to pain, stiffness, and reduced mobility. In the sacral and sacrococcygeal regions, this condition can manifest as chronic pain, inflammation, and potential neurological symptoms due to nerve compression. Patients may experience symptoms such as lower back pain, radiating pain to the legs, and difficulty in movement. The condition can be exacerbated by factors such as age, obesity, and previous spinal injuries. It is essential to differentiate this code from other spondylopathies, such as ankylosing spondylitis, which is an inflammatory condition leading to fusion of the spine. Accurate diagnosis and coding require a thorough understanding of the patient's history, physical examination findings, and imaging studies to rule out other conditions like spinal stenosis or inflammatory spine diseases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other spondylopathies like ankylosing spondylitis.
  • Need for comprehensive documentation of symptoms and imaging results.
  • Potential overlap with codes for spinal stenosis and other degenerative conditions.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the exact location of spondylosis.
  • Misdiagnosis or coding overlap with other spinal conditions.
  • Lack of imaging studies to support the diagnosis.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic lower back pain and radiculopathy.

Billing Considerations

Ensure clear documentation of the specific spinal regions affected and any neurological deficits.

Rheumatology

Documentation Requirements

Comprehensive history of symptoms, family history of inflammatory diseases, and laboratory results.

Common Clinical Scenarios

Patients with inflammatory back pain and suspected ankylosing spondylitis.

Billing Considerations

Differentiation from other inflammatory conditions is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M47.898 When
  • According to ICD
  • 10 guidelines, M47
  • 898 should be used when the spondylosis is not specified as ankylosing spondylitis or another specific type
  • It is important to document the clinical findings that support the diagnosis and to ensure that the condition is not due to trauma or other identifiable causes

Exclusion Criteria

Do NOT use M47.898 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

72040CPT Code

X-ray of the lumbar spine

Clinical Scenario

Used to evaluate for spondylosis in patients with chronic back pain.

Documentation Requirements

Document the reason for the X-ray and findings.

Specialty Considerations

Orthopedic specialists may require additional imaging for surgical planning.

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 diagnosis and treatment tracking. M47.898 provides a distinct code for other spondylosis types, enhancing data collection and research opportunities.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of diagnosis and treatment tracking. M47.898 provides a distinct code for other spondylosis types, enhancing data collection and research opportunities.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of diagnosis and treatment tracking. M47.898 provides a distinct code for other spondylosis types, enhancing data collection and research opportunities.

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 M47.898 and M45?

M47.898 is used for other types of spondylosis not classified as ankylosing spondylitis (M45), which is an inflammatory condition leading to spinal fusion.