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ICD-10 Guide
ICD-10 CodesM42.01

M42.01

Billable

Juvenile osteochondrosis of spine, occipito-atlanto-axial region

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

Code Description

ICD-10 M42.01 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, occipito-atlanto-axial region.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, specifically in the occipito-atlanto-axial region, is a condition characterized by the degeneration of cartilage and bone in the spinal area where the skull meets the spine. This condition typically affects children and adolescents, leading to pain, stiffness, and potential deformities in the cervical spine. The occipito-atlanto-axial region is crucial for head movement and stability, and any disruption can result in significant functional impairment. Symptoms may include neck pain, limited range of motion, and neurological deficits if spinal cord compression occurs. Diagnosis is often made through clinical evaluation and imaging studies, such as X-rays or MRI, which can reveal changes in bone structure and alignment. Treatment may involve physical therapy, pain management, and in severe cases, surgical intervention to correct deformities or relieve pressure on the spinal cord. Early diagnosis and management are essential to prevent long-term complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between juvenile osteochondrosis and other spinal disorders.
  • Understanding the specific anatomical location of the condition.
  • Documenting associated symptoms and their severity.
  • Navigating the potential need for surgical coding if procedures are performed.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to specify the anatomical location of the osteochondrosis.
  • Misclassification of the condition as a different spinal disorder.
  • Lack of supporting imaging studies in the medical record.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Evaluation of neck pain in adolescents, assessment of spinal deformities.

Billing Considerations

Consideration of growth patterns and developmental milestones in children.

Orthopedic Surgery

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Surgical intervention for severe spinal deformities or instability.

Billing Considerations

Documentation of surgical techniques and outcomes is critical for accurate coding.

Coding Guidelines

Inclusion Criteria

Use M42.01 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and anatomical location
  • Include any relevant co
  • morbidities or complications

Exclusion Criteria

Do NOT use M42.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Spinal fusion, occipito-atlanto-axial region

Clinical Scenario

Used when surgical intervention is required for severe osteochondrosis.

Documentation Requirements

Surgical notes must detail the procedure and any complications.

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 osteochondrosis, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of juvenile osteochondrosis, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of juvenile osteochondrosis, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management 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 are the common symptoms of juvenile osteochondrosis?

Common symptoms include neck pain, stiffness, limited range of motion, and potential neurological symptoms if there is spinal cord involvement.