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v1.0.0
ICD-10 Guide
ICD-10 CodesM47.11

M47.11

Billable

Other spondylosis with myelopathy, occipito-atlanto-axial region

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

Code Description

ICD-10 M47.11 is a billable code used to indicate a diagnosis of other spondylosis with myelopathy, occipito-atlanto-axial region.

Key Diagnostic Point:

M47.11 refers to a specific type of spondylosis characterized by degenerative changes in the cervical spine, particularly affecting the occipito-atlanto-axial region. This condition can lead to myelopathy, which is a neurological deficit resulting from compression of the spinal cord. Spondylosis in this area may arise from various factors, including age-related degeneration, trauma, or inflammatory conditions such as ankylosing spondylitis. Symptoms often include neck pain, stiffness, and neurological deficits such as weakness, numbness, or coordination issues in the upper extremities. Diagnosis typically involves imaging studies like MRI or CT scans to assess the degree of spinal canal narrowing and cord compression. Treatment may range from conservative management, including physical therapy and medications, to surgical interventions aimed at decompressing the spinal cord and stabilizing the spine.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of spondylosis and myelopathy.
  • Understanding the specific anatomical location of the occipito-atlanto-axial region.
  • Interpreting imaging results to confirm diagnosis.
  • Documenting neurological deficits accurately.

Audit Risk Factors

  • Inadequate documentation of neurological deficits.
  • Failure to provide imaging results supporting the diagnosis.
  • Misclassification of the type of spondylosis.
  • Lack of clarity on the relationship between symptoms and the diagnosis.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with neck pain and neurological symptoms, requiring differential diagnosis.

Billing Considerations

Ensure comprehensive documentation of neurological deficits and their impact on daily activities.

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients requiring surgical intervention for decompression of the spinal cord.

Billing Considerations

Document the rationale for surgical intervention and expected outcomes.

Coding Guidelines

Inclusion Criteria

Use M47.11 When
  • Follow official ICD
  • CM guidelines for coding spondylosis and myelopathy
  • Ensure accurate documentation of the condition's severity and associated symptoms
  • Include any relevant imaging studies to support the diagnosis

Exclusion Criteria

Do NOT use M47.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63075CPT Code

Laminectomy, cervical, for decompression of spinal cord

Clinical Scenario

Used in cases where surgical intervention is required for myelopathy due to spondylosis.

Documentation Requirements

Pre-operative assessment, imaging results, and surgical notes.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery and expected outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylosis and related conditions, improving the accuracy of diagnoses and treatment plans. M47.11 provides a clear distinction for cases involving myelopathy, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis and related conditions, improving the accuracy of diagnoses and treatment plans. M47.11 provides a clear distinction for cases involving myelopathy, which was less defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylosis and related conditions, improving the accuracy of diagnoses and treatment plans. M47.11 provides a clear distinction for cases involving myelopathy, which was less defined in ICD-9.

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 M47.11 and M47.12?

M47.11 refers specifically to spondylosis with myelopathy in the occipito-atlanto-axial region, while M47.12 pertains to myelopathy in the cervical region without specifying the occipito-atlanto-axial area.