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v1.0.0
ICD-10 Guide
ICD-10 CodesM51.1

M51.1

Billable

Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy

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

Code Description

ICD-10 M51.1 is a billable code used to indicate a diagnosis of thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy.

Key Diagnostic Point:

M51.1 refers to disorders of the intervertebral discs located in the thoracic, thoracolumbar, and lumbosacral regions of the spine that are associated with radiculopathy. Radiculopathy occurs when a nerve root in the spinal column becomes compressed or irritated, leading to symptoms such as pain, numbness, tingling, or weakness that radiate along the path of the affected nerve. Common causes of these disc disorders include herniation, degeneration, and trauma. Herniated discs occur when the inner gel-like core of the disc protrudes through the outer layer, potentially pressing on nearby nerve roots. This condition can lead to significant discomfort and functional impairment. Diagnosis typically involves clinical evaluation, imaging studies such as MRI or CT scans, and nerve conduction studies. Treatment options may include conservative management such as physical therapy, medications, and epidural steroid injections, or surgical interventions like discectomy or spinal fusion in more severe cases. Accurate coding is essential for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of disc disorders (e.g., herniated vs. degenerative)
  • Identifying the specific level of the spine affected
  • Documenting associated radiculopathy symptoms accurately
  • Understanding the need for additional codes for complications or related conditions

Audit Risk Factors

  • Inadequate documentation of radiculopathy symptoms
  • Failure to specify the level of the spine affected
  • Misclassification of disc disorders
  • Lack of supporting imaging studies in the medical record

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed surgical notes, imaging results, and pre-operative assessments.

Common Clinical Scenarios

Patients presenting with severe back pain and neurological deficits requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the surgical procedure performed and the rationale for surgery.

Neurology

Documentation Requirements

Comprehensive neurological evaluations, including detailed descriptions of radiculopathy symptoms.

Common Clinical Scenarios

Patients with chronic pain and neurological symptoms requiring conservative management or further diagnostic testing.

Billing Considerations

Document the progression of symptoms and response to treatment to support coding.

Coding Guidelines

Inclusion Criteria

Use M51.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include additional codes for any associated conditions or complications as necessary

Exclusion Criteria

Do NOT use M51.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63030CPT Code

Laminectomy, facetectomy, and foraminotomy

Clinical Scenario

Used in cases where surgical intervention is required for herniated discs causing radiculopathy.

Documentation Requirements

Operative reports detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons must document the specific levels treated and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of intervertebral disc disorders, improving the granularity of data for treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of intervertebral disc disorders, improving the granularity of data for treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of intervertebral disc disorders, improving the granularity of data for treatment outcomes and resource allocation.

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 M51.1 and M51.0?

M51.1 includes intervertebral disc disorders that are associated with radiculopathy, while M51.0 refers to disc disorders without radiculopathy.