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ICD-10 Guide
ICD-10 CodesM41.27

M41.27

Billable

Other idiopathic scoliosis, lumbosacral region

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

Code Description

ICD-10 M41.27 is a billable code used to indicate a diagnosis of other idiopathic scoliosis, lumbosacral region.

Key Diagnostic Point:

M41.27 refers to a specific type of idiopathic scoliosis that occurs in the lumbosacral region of the spine. Idiopathic scoliosis is characterized by an abnormal lateral curvature of the spine that typically develops during adolescence, although it can manifest at any age. The term 'idiopathic' indicates that the exact cause of the curvature is unknown, distinguishing it from scoliosis caused by other conditions such as congenital malformations or neuromuscular disorders. In the lumbosacral region, the curvature can lead to significant postural changes, discomfort, and potential complications if left untreated. Patients may present with asymmetry in shoulder height, waistline, or hip position. Diagnosis is typically confirmed through physical examination and imaging studies, such as X-rays, which help assess the degree of curvature and its impact on spinal alignment. Treatment options may vary based on the severity of the curvature and the patient's age, ranging from observation and bracing to surgical interventions like spinal fusion, which aims to stabilize the spine and prevent further progression of the deformity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of scoliosis
  • Need for precise documentation of curvature measurements
  • Differentiation from other types of scoliosis
  • Potential for co-existing spinal conditions

Audit Risk Factors

  • Inadequate documentation of curvature measurements
  • Failure to specify the idiopathic nature of the condition
  • Misclassification with other types of scoliosis
  • Lack of follow-up documentation for treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, curvature measurements, and treatment plans.

Common Clinical Scenarios

Surgical intervention for severe scoliosis, pre-operative assessments.

Billing Considerations

Ensure accurate documentation of the degree of curvature and any associated symptoms.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment progress notes, and patient-reported outcomes.

Common Clinical Scenarios

Conservative management of scoliosis with physical therapy.

Billing Considerations

Documenting the impact of scoliosis on daily activities and quality of life.

Coding Guidelines

Inclusion Criteria

Use M41.27 When
  • According to ICD
  • 10 guidelines, M41
  • 27 should be used when idiopathic scoliosis is confirmed in the lumbosacral region
  • It is important to document the specific curvature and any associated symptoms

Exclusion Criteria

Do NOT use M41.27 When
  • Exclusion criteria include scoliosis due to congenital or neuromuscular causes

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used for surgical correction of idiopathic scoliosis in the lumbosacral region.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of idiopathic scoliosis, improving the accuracy of data collection and reimbursement processes. M41.27 provides a clear distinction for idiopathic cases in the lumbosacral region, facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of idiopathic scoliosis, improving the accuracy of data collection and reimbursement processes. M41.27 provides a clear distinction for idiopathic cases in the lumbosacral region, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement processes. M41.27 provides a clear distinction for idiopathic cases in the lumbosacral region, facilitating better patient management and research.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons

Frequently Asked Questions

What is the difference between idiopathic scoliosis and other types of scoliosis?

Idiopathic scoliosis has no identifiable cause, while other types may result from congenital defects, neuromuscular conditions, or trauma. Accurate coding requires understanding these distinctions.