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ICD-10 Guide
ICD-10 CodesM48.1

M48.1

Billable

Ankylosing hyperostosis [Forestier]

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

Code Description

ICD-10 M48.1 is a billable code used to indicate a diagnosis of ankylosing hyperostosis [forestier].

Key Diagnostic Point:

Ankylosing hyperostosis, also known as Forestier's disease, is characterized by calcification and ossification of the anterior longitudinal ligament of the spine, leading to stiffness and reduced mobility. This condition primarily affects older adults and is often associated with other spondylopathies, including ankylosing spondylitis. Patients may present with back pain, stiffness, and a decreased range of motion, particularly in the thoracic and lumbar regions. The condition can lead to spinal stenosis, where the spinal canal narrows, potentially causing nerve compression and further complications. Diagnosis is typically made through imaging studies, such as X-rays or MRI, which reveal characteristic changes in the spine. Management may include physical therapy, pain management, and in severe cases, surgical intervention. Understanding the nuances of this condition is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other spondylopathies like ankylosing spondylitis.
  • Need for precise documentation of symptoms and imaging findings.
  • Potential overlap with spinal stenosis codes.
  • Variability in presentation and severity among patients.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the severity of symptoms.
  • Misclassification with other spondylopathies.
  • Lack of imaging results in the medical record.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on patient history, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with chronic back pain and stiffness, particularly in older adults.

Billing Considerations

Ensure to document any associated inflammatory conditions or comorbidities.

Orthopedics

Documentation Requirements

Surgical notes, imaging studies, and pre-operative assessments.

Common Clinical Scenarios

Patients requiring surgical intervention for spinal stenosis due to ankylosing hyperostosis.

Billing Considerations

Document the extent of spinal involvement and any neurological deficits.

Coding Guidelines

Inclusion Criteria

Use M48.1 When
  • According to ICD
  • 10 guidelines, M48
  • 1 should be used when the condition is specifically diagnosed and documented
  • It is important to include any relevant imaging findings and symptomatology to support the diagnosis

Exclusion Criteria

Do NOT use M48.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in surgical management of spinal stenosis due to ankylosing hyperostosis.

Documentation Requirements

Pre-operative assessment, imaging studies, and surgical notes.

Specialty Considerations

Orthopedic surgeons should document the extent of spinal involvement.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like ankylosing hyperostosis, improving the accuracy of patient records and facilitating better management of the condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like ankylosing hyperostosis, improving the accuracy of patient records and facilitating better management of the condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like ankylosing hyperostosis, improving the accuracy of patient records and facilitating better management of the condition.

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 primary symptom of ankylosing hyperostosis?

The primary symptom is chronic back pain and stiffness, particularly in older adults.

How is ankylosing hyperostosis diagnosed?

Diagnosis is made through clinical evaluation and imaging studies that reveal characteristic changes in the spine.