ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesM42.13

M42.13

Billable

Adult osteochondrosis of spine, cervicothoracic region

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

Code Description

ICD-10 M42.13 is a billable code used to indicate a diagnosis of adult osteochondrosis of spine, cervicothoracic region.

Key Diagnostic Point:

Adult osteochondrosis of the spine, specifically in the cervicothoracic region, refers to a degenerative condition affecting the vertebrae and intervertebral discs in the neck and upper back. This condition is characterized by the degeneration of cartilage and bone, leading to pain, stiffness, and potential deformities such as scoliosis, kyphosis, or lordosis. Patients may experience reduced mobility and discomfort, particularly during activities that involve neck movement. The cervicothoracic region is particularly susceptible to osteochondrosis due to the biomechanical stresses placed on the spine. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of degeneration and rule out other conditions. Treatment may include physical therapy, pain management, and in severe cases, surgical interventions such as spinal fusion to stabilize the affected vertebrae and alleviate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of spinal deformities.
  • Understanding the nuances of osteochondrosis versus other degenerative spine conditions.
  • The need for precise documentation of symptoms and imaging findings.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the severity of symptoms.
  • Failure to document imaging results that support the diagnosis.
  • Misclassification of the condition due to overlapping symptoms with other spinal disorders.
  • Inconsistent coding of associated spinal deformities.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic neck pain and limited range of motion, requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the surgical approach and any spinal fusion performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for pain management and mobility improvement.

Billing Considerations

Document functional limitations and response to therapy to support coding.

Coding Guidelines

Inclusion Criteria

Use M42.13 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the diagnosis, including any associated spinal deformities

Exclusion Criteria

Do NOT use M42.13 When
  • Exclude conditions that do not meet the criteria for osteochondrosis

Related ICD-10 Codes

Related CPT Codes

22630CPT Code

Spinal fusion, cervical

Clinical Scenario

Used when surgical intervention is required for osteochondrosis.

Documentation Requirements

Surgical notes detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like M42.13, improving the accuracy of diagnoses and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M42.13, improving the accuracy of diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like M42.13, improving the accuracy of diagnoses and treatment tracking.

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 primary cause of adult osteochondrosis?

Adult osteochondrosis is primarily caused by age-related degeneration of the spine, often exacerbated by factors such as repetitive stress, injury, and genetic predisposition.