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ICD-10 Guide
ICD-10 CodesM43.17

M43.17

Billable

Spondylolisthesis, lumbosacral region

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

Code Description

ICD-10 M43.17 is a billable code used to indicate a diagnosis of spondylolisthesis, lumbosacral region.

Key Diagnostic Point:

Spondylolisthesis is a condition characterized by the displacement of one vertebra over another, most commonly occurring in the lumbosacral region of the spine. This condition can lead to spinal instability, nerve compression, and pain. It is often classified into various types, including isthmic, degenerative, and traumatic spondylolisthesis. Symptoms may include lower back pain, leg pain, and neurological deficits depending on the severity of the slippage and nerve involvement. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to assess the degree of slippage and any associated spinal deformities. Treatment options range from conservative management, including physical therapy and pain management, to surgical interventions such as spinal fusion, which aims to stabilize the affected vertebrae. Understanding the nuances of spondylolisthesis is crucial for accurate coding and effective treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Differentiation between types of spondylolisthesis
  • Potential for associated spinal deformities (e.g., scoliosis, kyphosis)
  • Need for precise documentation of imaging findings

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of spondylolisthesis
  • Lack of imaging reports to support diagnosis
  • Improper linkage of diagnosis to treatment procedures

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical intervention for severe spondylolisthesis with associated radiculopathy.

Billing Considerations

Documentation must clearly outline the type of spondylolisthesis and any associated spinal deformities.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive evaluations, treatment plans, and progress notes.

Common Clinical Scenarios

Conservative management of spondylolisthesis with physical therapy.

Billing Considerations

Focus on functional limitations and response to non-surgical interventions.

Coding Guidelines

Inclusion Criteria

Use M43.17 When
  • According to ICD
  • 10 coding guidelines, M43
  • 17 should be used when spondylolisthesis is specifically identified in the lumbosacral region
  • Coders must ensure that the diagnosis is supported by clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M43.17 When
  • Exclusion criteria include conditions that do not involve vertebral slippage

Related ICD-10 Codes

Related CPT Codes

22630CPT Code

Lumbar spinal fusion

Clinical Scenario

Performed for stabilization in cases of severe spondylolisthesis.

Documentation Requirements

Operative report detailing the procedure, indications, and post-operative care.

Specialty Considerations

Orthopedic surgeons must document the type of spondylolisthesis and any associated conditions.

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 diagnosis and treatment tracking. This specificity aids in better patient management 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 diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylolisthesis, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management 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 involves the slippage of a vertebra, while spondylolysis refers to a defect in the vertebra without slippage.