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ICD-10 Guide
ICD-10 CodesM42.04

M42.04

Billable

Juvenile osteochondrosis of spine, thoracic region

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

Code Description

ICD-10 M42.04 is a billable code used to indicate a diagnosis of juvenile osteochondrosis of spine, thoracic region.

Key Diagnostic Point:

Juvenile osteochondrosis of the spine, particularly in the thoracic region, is a condition characterized by the degeneration of the vertebral growth plates and associated structures during the developmental years. This condition often manifests as pain, stiffness, and potential deformities in the spine, including scoliosis, kyphosis, or lordosis. The thoracic spine is particularly susceptible due to its structural role and the mechanical stresses placed upon it during growth spurts. Patients may present with postural changes, limited range of motion, and discomfort that can affect their daily activities. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and a thorough assessment of the patient's history. Treatment may include physical therapy, bracing, or surgical intervention, particularly in cases where spinal deformities progress or cause significant functional impairment. Understanding the implications of juvenile osteochondrosis is crucial for managing potential long-term outcomes, including the risk of chronic pain or further spinal deformities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between juvenile osteochondrosis and other spinal conditions.
  • Understanding the implications of associated spinal deformities.
  • Navigating the treatment options and their documentation requirements.
  • Recognizing the age-related factors in diagnosis and treatment.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to document associated spinal deformities.
  • Lack of clarity in treatment plans and outcomes.
  • Misinterpretation of imaging studies.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with back pain, postural abnormalities, or referrals for surgical evaluation.

Billing Considerations

Ensure comprehensive documentation of growth patterns and any interventions undertaken.

Pediatrics

Documentation Requirements

Thorough history taking, including developmental milestones and family history of spinal conditions.

Common Clinical Scenarios

Children with complaints of back pain or visible spinal deformities.

Billing Considerations

Consideration of growth and development stages in treatment planning.

Coding Guidelines

Inclusion Criteria

Use M42.04 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated deformities
  • Include specific details about the patient's age and developmental stage, as these factors influence treatment and management

Exclusion Criteria

Do NOT use M42.04 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22554CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in cases of severe juvenile osteochondrosis with significant spinal deformity.

Documentation Requirements

Pre-operative assessment, imaging studies, and surgical notes.

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 data collection and treatment tracking. This specificity aids in better understanding the condition's prevalence and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of juvenile osteochondrosis, improving the accuracy of data collection and treatment tracking. This specificity aids in better understanding the condition's prevalence and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of juvenile osteochondrosis, improving the accuracy of data collection and treatment tracking. This specificity aids in better understanding the condition's prevalence and outcomes.

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 back pain, stiffness, and visible spinal deformities such as scoliosis or kyphosis. Patients may also experience discomfort during physical activities.