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ICD-10 Guide
ICD-10 CodesM47.818

M47.818

Billable

Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region

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

Code Description

ICD-10 M47.818 is a billable code used to indicate a diagnosis of spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region.

Key Diagnostic Point:

Spondylosis is a degenerative condition affecting the spine, characterized by the degeneration of intervertebral discs and the formation of osteophytes (bone spurs). In the sacral and sacrococcygeal region, this condition can lead to chronic pain and stiffness without the presence of myelopathy (spinal cord dysfunction) or radiculopathy (nerve root dysfunction). Patients may experience localized pain, reduced mobility, and discomfort during activities. The condition is often associated with aging, repetitive stress, and genetic predisposition. Unlike ankylosing spondylitis, which is an inflammatory condition leading to fusion of the spine, spondylosis is primarily degenerative. Spinal stenosis, which can occur in conjunction with spondylosis, involves narrowing of the spinal canal, potentially leading to nerve compression. Inflammatory spine conditions may also coexist, necessitating careful evaluation and management. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the degree of degeneration and rule out other conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between spondylosis and other spinal conditions like ankylosing spondylitis.
  • Understanding the absence of myelopathy or radiculopathy in documentation.
  • Identifying the specific sacral and sacrococcygeal regions in imaging reports.
  • Navigating the overlap with other codes related to spinal degeneration.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Misclassification of spondylosis as inflammatory or infectious conditions.
  • Failure to specify the sacral and sacrococcygeal regions in coding.
  • Inconsistent use of related codes for coexisting conditions.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic lower back pain, stiffness, and limited mobility.

Billing Considerations

Documentation should clearly differentiate between degenerative and inflammatory conditions.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments including functional limitations and treatment responses.

Common Clinical Scenarios

Rehabilitation following spinal surgery or conservative management of chronic pain.

Billing Considerations

Focus on functional outcomes and patient-reported outcomes in documentation.

Coding Guidelines

Inclusion Criteria

Use M47.818 When
  • According to ICD
  • 10 guidelines, M47
  • 818 should be used when there is clear documentation of spondylosis without neurological involvement
  • It is important to ensure that the diagnosis is supported by imaging and clinical findings

Exclusion Criteria

Do NOT use M47.818 When
  • Exclusion criteria include conditions that involve myelopathy or radiculopathy

Related ICD-10 Codes

Related CPT Codes

72040CPT Code

Radiologic examination, spine, complete, including flexion and extension views, if performed.

Clinical Scenario

Used to evaluate the extent of spondylosis in the sacral region.

Documentation Requirements

Radiology report must specify findings related to spondylosis.

Specialty Considerations

Orthopedic specialists often order these studies for diagnosis.

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. M47.818 provides a clear distinction from other spinal conditions, facilitating better patient management and research.

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. M47.818 provides a clear distinction from other spinal conditions, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement. M47.818 provides a clear distinction from other spinal conditions, facilitating better patient management and research.

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 ankylosing spondylitis?

Spondylosis is a degenerative condition characterized by disc degeneration and osteophyte formation, while ankylosing spondylitis is an inflammatory condition that can lead to spinal fusion. Spondylosis does not involve myelopathy or radiculopathy, whereas ankylosing spondylitis can.