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ICD-10 Guide
ICD-10 CodesM42.19

M42.19

Billable

Adult osteochondrosis of spine, multiple sites in spine

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

Code Description

ICD-10 M42.19 is a billable code used to indicate a diagnosis of adult osteochondrosis of spine, multiple sites in spine.

Key Diagnostic Point:

Adult osteochondrosis of the spine refers to a degenerative condition affecting the intervertebral discs and vertebrae, leading to pain, stiffness, and potential deformities. This condition is characterized by the degeneration of cartilage and bone, often resulting in osteophyte formation and disc herniation. In cases where multiple sites in the spine are affected, patients may experience a range of symptoms including chronic back pain, reduced mobility, and neurological deficits due to nerve compression. The condition can lead to spinal deformities such as scoliosis (lateral curvature of the spine), kyphosis (excessive outward curvature), and lordosis (excessive inward curvature). Treatment may involve conservative management, physical therapy, or surgical interventions such as spinal fusion to stabilize affected vertebrae and alleviate pain. Accurate coding is essential for proper treatment reimbursement and tracking of patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between multiple sites of osteochondrosis
  • Identifying associated spinal deformities
  • Documenting the severity and impact on function
  • Understanding the relationship with other spinal conditions

Audit Risk Factors

  • Inadequate documentation of multiple sites affected
  • Failure to document associated spinal deformities
  • Misclassification of the severity of the condition
  • Inconsistent coding of treatment procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients undergoing spinal fusion due to osteochondrosis with deformities.

Billing Considerations

Ensure clear documentation of the specific vertebrae involved and the type of deformity present.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations of functional limitations and treatment plans.

Common Clinical Scenarios

Patients receiving rehabilitation for pain management and mobility improvement.

Billing Considerations

Document the impact of osteochondrosis on daily activities and the effectiveness of interventions.

Coding Guidelines

Inclusion Criteria

Use M42.19 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details about the specific sites affected and any associated conditions

Exclusion Criteria

Do NOT use M42.19 When
  • Exclude conditions that are not related to osteochondrosis

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, lumbar

Clinical Scenario

Used when performing a spinal fusion for osteochondrosis with instability.

Documentation Requirements

Surgical notes detailing the procedure, indications, and post-operative care.

Specialty Considerations

Orthopedic surgeons should ensure that the diagnosis aligns with the 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 conditions like osteochondrosis, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like osteochondrosis, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 difference between M42.19 and M42.00?

M42.19 specifies multiple sites affected by osteochondrosis, while M42.00 is used when the site is unspecified.