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ICD-10 Guide
ICD-10 CodesM43.15

M43.15

Billable

Spondylolisthesis, thoracolumbar region

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

Code Description

ICD-10 M43.15 is a billable code used to indicate a diagnosis of spondylolisthesis, thoracolumbar region.

Key Diagnostic Point:

Spondylolisthesis is a condition characterized by the displacement of one vertebra over another, commonly occurring in the thoracolumbar region of the spine. This condition can lead to spinal instability, pain, and neurological symptoms due to nerve root compression. It is often classified into various types, including isthmic, degenerative, and traumatic spondylolisthesis. The thoracolumbar region, which includes the lower thoracic and upper lumbar vertebrae, is particularly susceptible due to its biomechanical load and mobility. Patients may present with symptoms such as lower back pain, leg pain, and muscle weakness. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess vertebral alignment and any associated spinal deformities. Treatment options may range from conservative management, including physical therapy and pain management, to surgical interventions such as spinal fusion, which aims to stabilize the affected vertebrae and alleviate symptoms. Understanding the nuances of spondylolisthesis is crucial for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (e.g., degenerative vs. traumatic)
  • Potential for associated spinal deformities (e.g., scoliosis, kyphosis)
  • Variability in clinical presentation and severity
  • Need for precise documentation of imaging findings

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the type of spondylolisthesis
  • Lack of imaging reports to support the diagnosis
  • Incorrect linkage of diagnosis to surgical procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging studies, and pre-operative assessments are essential for accurate coding.

Common Clinical Scenarios

Patients presenting with severe back pain and neurological deficits requiring surgical intervention.

Billing Considerations

Documentation must clearly indicate the type of spondylolisthesis and any associated procedures performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations including functional assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing conservative management for spondylolisthesis with physical therapy.

Billing Considerations

Focus on documenting the impact of the condition on daily activities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use M43.15 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated spinal deformities
  • Include relevant imaging findings and treatment plans

Exclusion Criteria

Do NOT use M43.15 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, posterior technique

Clinical Scenario

Used in surgical treatment of spondylolisthesis to stabilize the spine.

Documentation Requirements

Operative report detailing the procedure, indication, and any complications.

Specialty Considerations

Orthopedic surgeons must document the type of spondylolisthesis and the specific vertebrae involved.

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. This specificity aids in better tracking of treatment outcomes and resource allocation.

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. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 spondylolisthesis and spondylolysis?

Spondylolisthesis refers to the forward displacement of a vertebra, while spondylolysis is a defect in the pars interarticularis of the vertebra, which may lead to spondylolisthesis.