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ICD-10 Guide
ICD-10 CodesM42.17

M42.17

Billable

Adult osteochondrosis of spine, lumbosacral region

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

Code Description

ICD-10 M42.17 is a billable code used to indicate a diagnosis of adult osteochondrosis of spine, lumbosacral region.

Key Diagnostic Point:

Adult osteochondrosis of the spine, specifically in the lumbosacral region, refers to a degenerative condition affecting the intervertebral discs and vertebrae. This condition is characterized by the degeneration of cartilage and bone, leading to pain, stiffness, and potential deformities in the spine. Patients may experience symptoms such as lower back pain, limited mobility, and neurological symptoms if nerve roots are compressed. Osteochondrosis can lead to complications such as spinal deformities, including scoliosis (lateral curvature of the spine), kyphosis (excessive outward curvature), and lordosis (excessive inward curvature). These deformities can further complicate the clinical picture and may necessitate surgical interventions such as spinal fusion to stabilize the spine and alleviate pain. The lumbosacral region is particularly susceptible due to its weight-bearing role and the stress it endures during daily activities. Accurate diagnosis often involves imaging studies, including X-rays or MRI, to assess the extent of degeneration and any associated deformities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of spinal deformities
  • Understanding the relationship between osteochondrosis and other spinal conditions
  • Documenting the severity and impact of symptoms on daily activities
  • Navigating the coding for potential surgical interventions

Audit Risk Factors

  • Inadequate documentation of symptoms and their impact
  • Failure to document associated spinal deformities
  • Incorrect linkage of diagnosis to surgical procedures
  • Lack of imaging studies to support the diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic lower back pain, spinal deformities, or those requiring surgical intervention.

Billing Considerations

Documentation should clearly outline the rationale for surgical procedures and any conservative treatments attempted.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and treatment progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for pain management and mobility improvement.

Billing Considerations

Focus on documenting the patient's functional status and response to therapy.

Coding Guidelines

Inclusion Criteria

Use M42.17 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies and treatment plans

Exclusion Criteria

Do NOT use M42.17 When
  • Exclude conditions that are not directly related to osteochondrosis

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, lumbar

Clinical Scenario

Used when surgical intervention is required for osteochondrosis with deformity.

Documentation Requirements

Operative reports detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and any pre-operative assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of osteochondrosis, improving the accuracy of data collection and reimbursement processes. M42.17 provides a clear distinction for lumbosacral involvement, which is critical for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteochondrosis, improving the accuracy of data collection and reimbursement processes. M42.17 provides a clear distinction for lumbosacral involvement, which is critical for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M42.17 provides a clear distinction for lumbosacral involvement, which is critical for treatment planning.

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 M42.17?

Common symptoms include chronic lower back pain, stiffness, and potential neurological symptoms due to nerve root compression.