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ICD-10 Guide
DiagnosesLumbar Spondylosis With Radiculopathy

Lumbar Spondylosis With Radiculopathy

ICD-10 Coding for Lumbar Spondylosis with Radiculopathy(M47.27, M51.16)

PRIMARY SPECIALTYOrthopedics
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Lumbar Spondylosis With Radiculopathy?
Essential facts and insights about Lumbar Spondylosis with Radiculopathy

Key Clinical Considerations:

  • Chronic lower back pain
  • Radiating pain in the lower extremities
  • Numbness or tingling in the legs
  • Muscle weakness in the legs
  • Reduced reflexes in the lower limbs

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including onset and duration of symptoms
  • Results of imaging studies (MRI, CT) showing degenerative changes
  • Neurological examination findings
  • Functional limitations due to radiculopathy

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding spondylosis with and without radiculopathy.
  • Common errors include misclassifying the severity of radiculopathy.

Code Exclusions

Important Exclusions

  • Acute lumbar disc herniation
  • Other specific lumbar spine disorders
  • Alternative codes for non-radicular pain

Related ICD-10 Codes

Primary Codes
M47.26
Lumbar spondylosis with radiculopathy
Ancillary Codes
M54.16
Differential Codes
M51.16
M47.27

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Adults aged 40 and older
  • Patients with chronic back pain in orthopedic settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient history, physical exam findings, and imaging results.

What are the billing considerations?

Ensure accurate coding to reflect the severity and complexity of the condition.