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ICD-10 Guide
ICD-10 CodesChapter 13: Diseases of the musculoskeletal systemM47

M47

Billable

Spondylosis

Chapter 13:Diseases of the musculoskeletal system

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

Code Description

ICD-10 M47 is a billable code used to indicate a diagnosis of spondylosis.

Key Diagnostic Point:

Spondylosis refers to a degenerative condition of the spine characterized by the degeneration of intervertebral discs and the formation of osteophytes (bone spurs). It is commonly associated with aging and can lead to various spinal disorders, including spondylopathies, spinal stenosis, and ankylosing spondylitis. Spondylosis can manifest as pain, stiffness, and reduced mobility in the affected areas of the spine. The condition may also result in nerve compression, leading to radicular symptoms such as numbness or weakness in the limbs. Inflammatory spine conditions, such as ankylosing spondylitis, are characterized by chronic inflammation of the spine and sacroiliac joints, which can lead to fusion of the vertebrae over time. Diagnosis typically involves clinical evaluation, imaging studies, and sometimes laboratory tests to rule out other conditions. Treatment options may include physical therapy, medications for pain relief, and in severe cases, surgical intervention. Understanding the nuances of spondylosis is crucial for accurate coding and appropriate management of patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of related conditions (e.g., ankylosing spondylitis, spinal stenosis)
  • Differentiation between acute and chronic presentations
  • Need for precise documentation of symptoms and imaging findings
  • Potential for co-morbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of spondylosis
  • Misclassification of spondylosis as a more severe condition
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, clinical notes on physical examination, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic back pain, radiculopathy, or post-surgical follow-ups.

Billing Considerations

Ensure that all relevant imaging studies are documented and correlate with clinical findings.

Rheumatology

Documentation Requirements

Comprehensive history of symptoms, laboratory tests for inflammatory markers, and imaging studies.

Common Clinical Scenarios

Patients with inflammatory back pain, stiffness, and systemic symptoms.

Billing Considerations

Document the duration and severity of symptoms to differentiate between inflammatory and degenerative conditions.

Coding Guidelines

Inclusion Criteria

Use M47 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the specific type of spondylosis and any associated conditions
  • Include details on the severity and duration of symptoms, as well as any imaging results

Exclusion Criteria

Do NOT use M47 When
No specific exclusions found.

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for patients with spondylosis experiencing joint pain.

Documentation Requirements

Document the joint involved, reason for the procedure, and any imaging studies.

Specialty Considerations

Orthopedic specialists should ensure that the procedure is justified based on clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylosis, enabling better tracking of the condition and its complications. This specificity aids in research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis, enabling better tracking of the condition and its complications. This specificity aids in research and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylosis, enabling better tracking of the condition and its complications. This specificity aids in research and treatment planning.

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 spondylosis and spondylitis?

Spondylosis is a degenerative condition of the spine, while spondylitis refers to inflammation of the spine. Spondylitis is often associated with autoimmune conditions, whereas spondylosis is primarily related to aging and wear and tear.