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ICD-10 Guide
ICD-10 CodesM47.817

M47.817

Billable

Spondylosis without myelopathy or radiculopathy, lumbosacral region

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

Code Description

ICD-10 M47.817 is a billable code used to indicate a diagnosis of spondylosis without myelopathy or radiculopathy, lumbosacral region.

Key Diagnostic Point:

Spondylosis refers to degenerative changes in the spine, particularly affecting the intervertebral discs and vertebrae. In the lumbosacral region, these changes can lead to pain, stiffness, and reduced mobility. Unlike spondylitis, which involves inflammation, spondylosis is characterized by wear and tear, often due to aging or repetitive stress. Patients may experience localized pain in the lower back, which can be exacerbated by certain movements or prolonged positions. Importantly, this condition does not involve myelopathy (spinal cord dysfunction) or radiculopathy (nerve root dysfunction), which distinguishes it from more severe spinal conditions. Diagnosis typically involves clinical evaluation, imaging studies such as X-rays or MRI, and a thorough review of the patient's history. Treatment may include physical therapy, pain management, and lifestyle modifications to alleviate symptoms and improve function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spondylosis and other spinal conditions like spondylitis or spinal stenosis.
  • Understanding the absence of myelopathy or radiculopathy in the diagnosis.
  • Proper documentation of symptoms and imaging findings.
  • Navigating the nuances of coding for degenerative versus inflammatory conditions.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Misclassification of spondylosis as spondylitis or stenosis.
  • Failure to specify the lumbosacral region.
  • Inconsistent coding across different encounters.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic lower back pain, limited mobility, or post-surgical follow-ups.

Billing Considerations

Ensure clear differentiation from inflammatory conditions and document any conservative management strategies.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes.

Common Clinical Scenarios

Patients undergoing rehabilitation for chronic back pain or post-injury recovery.

Billing Considerations

Document the impact of spondylosis on daily activities and rehabilitation outcomes.

Coding Guidelines

Inclusion Criteria

Use M47.817 When
  • According to ICD
  • 10 guidelines, M47
  • 817 should be used when spondylosis is confirmed without accompanying myelopathy or radiculopathy
  • Documentation must clearly indicate the absence of these conditions and specify the lumbosacral region

Exclusion Criteria

Do NOT use M47.817 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97001CPT Code

Physical therapy evaluation

Clinical Scenario

Used for initial assessment of a patient with spondylosis.

Documentation Requirements

Detailed evaluation of physical function and pain levels.

Specialty Considerations

Orthopedic specialists should document specific functional limitations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of data collection and reimbursement processes. M47.817 provides a clear distinction from inflammatory conditions, which is crucial for appropriate management and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylosis, improving the accuracy of data collection and reimbursement processes. M47.817 provides a clear distinction from inflammatory conditions, which is crucial for appropriate management and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M47.817 provides a clear distinction from inflammatory conditions, which is crucial for appropriate management 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 characterized by wear and tear of the spine, while spondylitis is an inflammatory condition that can lead to pain and stiffness, often associated with autoimmune diseases.