ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM41.116

M41.116

Billable

Juvenile idiopathic scoliosis, lumbar region

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

Code Description

ICD-10 M41.116 is a billable code used to indicate a diagnosis of juvenile idiopathic scoliosis, lumbar region.

Key Diagnostic Point:

Juvenile idiopathic scoliosis (JIS) is a form of scoliosis that occurs in children aged 4 to 10 years, characterized by an abnormal lateral curvature of the spine. The lumbar region is specifically affected in this code, indicating that the curvature is primarily located in the lower back. The etiology of JIS remains largely unknown, hence the term 'idiopathic.' Clinically, it is essential to differentiate JIS from other types of scoliosis, such as congenital or neuromuscular scoliosis. Diagnosis typically involves a physical examination, assessment of spinal curvature using the Cobb angle, and imaging studies like X-rays. Treatment options vary based on the severity of the curvature and may include observation, bracing, or surgical intervention, such as spinal fusion, to correct the deformity and prevent progression. Early detection and management are crucial to minimize complications and improve functional outcomes. The condition can lead to significant psychosocial impacts due to its visible nature and potential physical limitations, making comprehensive care essential.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of scoliosis
  • Need for precise documentation of curvature measurements
  • Variability in treatment approaches based on severity
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of curvature measurements
  • Failure to specify the idiopathic nature of the condition
  • Lack of follow-up documentation on treatment efficacy
  • Misclassification of scoliosis type

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Initial diagnosis of scoliosis, monitoring progression, and surgical intervention planning.

Billing Considerations

Ensure accurate Cobb angle measurements are documented and specify the lumbar region involvement.

Pediatrics

Documentation Requirements

Growth charts, family history, and developmental milestones should be included.

Common Clinical Scenarios

Routine screening for scoliosis in school-aged children and management of mild cases.

Billing Considerations

Document psychosocial impacts and family concerns regarding the child's condition.

Coding Guidelines

Inclusion Criteria

Use M41.116 When
  • Follow official ICD
  • CM guidelines for coding scoliosis, ensuring to document the idiopathic nature and specific region affected
  • Include any relevant co
  • morbidities and treatment plans

Exclusion Criteria

Do NOT use M41.116 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22558CPT Code

Spinal fusion, lumbar

Clinical Scenario

Used when surgical intervention is required for severe idiopathic scoliosis.

Documentation Requirements

Operative reports detailing the procedure, indications, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and expected outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of juvenile idiopathic scoliosis, improving the ability to track and manage this condition effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of juvenile idiopathic scoliosis, improving the ability to track and manage this condition effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of juvenile idiopathic scoliosis, improving the ability to track and manage this condition effectively.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons (AAOS)

Frequently Asked Questions

What is the age range for juvenile idiopathic scoliosis?

Juvenile idiopathic scoliosis typically occurs in children aged 4 to 10 years.

How is juvenile idiopathic scoliosis diagnosed?

Diagnosis is made through physical examination and imaging studies, particularly X-rays to measure the curvature of the spine.

What are the treatment options for juvenile idiopathic scoliosis?

Treatment options include observation, bracing, and surgical intervention, depending on the severity of the curvature.