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ICD-10 Guide
ICD-10 CodesM43.4

M43.4

Billable

Other recurrent atlantoaxial dislocation

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

Code Description

ICD-10 M43.4 is a billable code used to indicate a diagnosis of other recurrent atlantoaxial dislocation.

Key Diagnostic Point:

Other recurrent atlantoaxial dislocation refers to a condition characterized by the abnormal displacement of the first cervical vertebra (atlas) relative to the second cervical vertebra (axis). This dislocation can occur repeatedly due to various underlying factors, including congenital anomalies, trauma, or degenerative changes. The atlantoaxial joint is crucial for head rotation and stability, and recurrent dislocation can lead to significant neurological complications, including spinal cord compression. Symptoms may include neck pain, restricted range of motion, and neurological deficits such as weakness or sensory changes. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the alignment and integrity of the cervical spine. Treatment options may vary from conservative management, including physical therapy and bracing, to surgical interventions like spinal fusion to stabilize the joint and prevent further dislocation. Understanding the complexities of this condition is essential for accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of recurrent episodes
  • Differentiation from other types of cervical dislocations
  • Potential for associated neurological conditions

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to document associated neurological symptoms
  • Misclassification with other cervical spine conditions
  • Lack of clarity on treatment interventions

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical intervention for recurrent dislocation, management of associated neurological deficits.

Billing Considerations

Ensure documentation reflects the complexity of the case and any co-morbidities.

Neurology

Documentation Requirements

Neurological assessments, imaging studies, and treatment plans.

Common Clinical Scenarios

Evaluation of neurological symptoms related to atlantoaxial dislocation.

Billing Considerations

Document neurological findings thoroughly to support coding for associated conditions.

Coding Guidelines

Inclusion Criteria

Use M43.4 When
  • According to ICD
  • 10 guidelines, M43
  • 4 should be used when there is clear documentation of recurrent atlantoaxial dislocation
  • Coders must ensure that the diagnosis is supported by imaging and clinical findings

Exclusion Criteria

Do NOT use M43.4 When
  • Exclusion criteria include conditions that do not involve recurrent dislocation

Related ICD-10 Codes

Related CPT Codes

22612CPT Code

Spinal fusion, cervical, anterior approach

Clinical Scenario

Used in surgical management of recurrent atlantoaxial dislocation.

Documentation Requirements

Surgical notes, imaging studies, and pre-operative assessments.

Specialty Considerations

Orthopedic surgeons must document the rationale for fusion and any complications.

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 recurrent atlantoaxial dislocation, 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 conditions like recurrent atlantoaxial dislocation, 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 difference between M43.4 and M43.3?

M43.4 refers specifically to recurrent atlantoaxial dislocation, while M43.3 covers other types of cervical vertebra dislocations that may not be recurrent.