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ICD-10 Guide
ICD-10 CodesM42.03

M42.03

Billable

Juvenile osteochondrosis of spine, cervicothoracic region

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

Code Description

ICD-10 M42.03 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, cervicothoracic region.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, specifically in the cervicothoracic region, is a condition characterized by the degeneration of the vertebral growth plates and associated structures in children and adolescents. This condition often manifests as pain, stiffness, and potential deformities in the spine, including scoliosis, kyphosis, or lordosis. The cervicothoracic region, which encompasses the cervical and upper thoracic vertebrae, is particularly susceptible to these changes due to the mechanical stresses placed on it during growth spurts. The pathophysiology involves ischemic necrosis of the vertebral endplates, leading to altered bone remodeling and potential vertebral collapse. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and assessment of functional limitations. Treatment may include physical therapy, bracing, or surgical intervention, such as spinal fusion, in severe cases to stabilize the spine and correct deformities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for precise documentation of spinal deformities
  • Differentiation from other spinal conditions
  • Potential for co-morbidities affecting treatment

Audit Risk Factors

  • Inadequate documentation of the specific spinal region affected
  • Failure to document associated spinal deformities
  • Misclassification of the severity of the condition
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed surgical notes, imaging studies, and pre/post-operative assessments.

Common Clinical Scenarios

Surgical intervention for severe spinal deformities, post-operative follow-ups.

Billing Considerations

Ensure clear documentation of the surgical approach and any complications.

Pediatrics

Documentation Requirements

Growth charts, developmental assessments, and detailed history of symptoms.

Common Clinical Scenarios

Management of pain and functional limitations in children with osteochondrosis.

Billing Considerations

Documenting growth patterns and any impact on daily activities.

Coding Guidelines

Inclusion Criteria

Use M42.03 When
  • Follow official ICD
  • CM guidelines for coding osteochondrosis, ensuring accurate documentation of the specific spinal region and any associated conditions
  • Include details on the severity and treatment plan

Exclusion Criteria

Do NOT use M42.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in cases of severe spinal deformity correction.

Documentation Requirements

Surgical notes, imaging studies, and pre-operative assessments.

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 juvenile osteochondrosis, improving the accuracy of diagnosis 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 diagnosis 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 diagnosis 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 localized pain in the cervicothoracic region, stiffness, and potential deformities such as scoliosis or kyphosis. Patients may also experience functional limitations in daily activities.