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ICD-10 Guide
ICD-10 CodesM43.12

M43.12

Billable

Spondylolisthesis, cervical region

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

Code Description

ICD-10 M43.12 is a billable code used to indicate a diagnosis of spondylolisthesis, cervical region.

Key Diagnostic Point:

Spondylolisthesis in the cervical region refers to the anterior displacement of one cervical vertebra over another. This condition can result from various factors, including congenital defects, degenerative changes, trauma, or pathological conditions such as tumors. Patients may present with neck pain, radiculopathy, or myelopathy due to spinal cord compression. The cervical spine is particularly vulnerable due to its mobility and the weight it bears. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess vertebral alignment and any associated spinal canal narrowing. Treatment options range from conservative management, including physical therapy and pain management, to surgical interventions like spinal fusion, which aims to stabilize the affected vertebrae and alleviate symptoms. Understanding the underlying cause of spondylolisthesis is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms among patients
  • Need for precise imaging documentation
  • Differentiation from other spinal deformities like scoliosis or kyphosis
  • Potential for co-existing conditions requiring additional coding

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to document imaging results clearly
  • Misclassification of the type of spondylolisthesis
  • Lack of clarity on treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative evaluations.

Common Clinical Scenarios

Patients presenting with neck pain and neurological symptoms requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the surgical approach and any complications.

Neurology

Documentation Requirements

Comprehensive neurological assessments and imaging interpretations.

Common Clinical Scenarios

Patients with cervical spondylolisthesis presenting with radiculopathy or myelopathy.

Billing Considerations

Document neurological deficits and their correlation with imaging findings.

Coding Guidelines

Inclusion Criteria

Use M43.12 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated complications
  • Include relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M43.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, cervical

Clinical Scenario

Used in surgical management of cervical spondylolisthesis.

Documentation Requirements

Operative report detailing the procedure and indications.

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 spondylolisthesis, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylolisthesis, improving the accuracy of data collection 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 primary cause of cervical spondylolisthesis?

Cervical spondylolisthesis can result from degenerative changes, trauma, or congenital defects. It is essential to identify the underlying cause for appropriate management.