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v1.0.0
ICD-10 Guide
ICD-10 CodesM41.87

M41.87

Billable

Other forms of scoliosis, lumbosacral region

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

Code Description

ICD-10 M41.87 is a billable code used to indicate a diagnosis of other forms of scoliosis, lumbosacral region.

Key Diagnostic Point:

M41.87 refers to various atypical forms of scoliosis affecting the lumbosacral region of the spine. Scoliosis is characterized by an abnormal lateral curvature of the spine, which can lead to significant postural changes and functional impairments. The lumbosacral region, which includes the lower back and sacrum, is particularly susceptible to deformities due to factors such as congenital anomalies, neuromuscular conditions, or degenerative diseases. Patients may present with symptoms such as back pain, uneven shoulders or hips, and limited mobility. Diagnosis typically involves physical examination and imaging studies like X-rays or MRI to assess the curvature and its impact on surrounding structures. Treatment options vary based on severity and may include physical therapy, bracing, or surgical interventions such as spinal fusion to correct the curvature and stabilize the spine. Accurate coding is essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to scoliosis
  • Differentiation from other spinal deformities like kyphosis and lordosis
  • Need for precise documentation of curvature measurements
  • Potential for coexisting conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of the specific type of scoliosis
  • Failure to document the severity of the curvature
  • Lack of clarity on the underlying cause of scoliosis
  • Improper linkage between diagnosis and treatment procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical correction of scoliosis, evaluation of scoliosis progression in adolescents.

Billing Considerations

Ensure documentation reflects the specific type of scoliosis and any associated conditions.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments including functional limitations and treatment plans.

Common Clinical Scenarios

Rehabilitation post-surgery, management of pain and mobility issues.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use M41.87 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the specific type of scoliosis is documented
  • Include any relevant modifiers to indicate the complexity of the case

Exclusion Criteria

Do NOT use M41.87 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used for surgical correction of scoliosis in patients with significant curvature.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons must document the specific type of scoliosis and any pre-existing conditions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving the accuracy of diagnoses and treatment plans. M41.87 provides a distinct code for atypical forms of scoliosis, enhancing the granularity of data for clinical and research purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving the accuracy of diagnoses and treatment plans. M41.87 provides a distinct code for atypical forms of scoliosis, enhancing the granularity of data for clinical and research purposes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of scoliosis types, improving the accuracy of diagnoses and treatment plans. M41.87 provides a distinct code for atypical forms of scoliosis, enhancing the granularity of data for clinical and research purposes.

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 M41.87 and M41.1?

M41.87 is used for other forms of scoliosis that are not idiopathic, while M41.1 specifically refers to idiopathic scoliosis, which has no known cause.