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v1.0.0
ICD-10 Guide
ICD-10 CodesM47.891

M47.891

Billable

Other spondylosis, occipito-atlanto-axial region

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

Code Description

ICD-10 M47.891 is a billable code used to indicate a diagnosis of other spondylosis, occipito-atlanto-axial region.

Key Diagnostic Point:

M47.891 refers to a specific type of spondylosis affecting the occipito-atlanto-axial region of the spine, which includes the junction between the skull (occiput) and the first two cervical vertebrae (atlas and axis). Spondylosis is a degenerative condition characterized by the wear and tear of the spinal discs and joints, leading to pain, stiffness, and reduced mobility. In the occipito-atlanto-axial region, this condition can result in significant neurological symptoms due to the proximity of the spinal cord and brainstem. Patients may present with neck pain, headaches, and in severe cases, neurological deficits such as weakness or sensory changes in the upper extremities. The condition can be exacerbated by inflammatory spine conditions such as ankylosing spondylitis, which can lead to further degeneration and fusion of the vertebrae. Diagnosis typically involves imaging studies such as X-rays or MRI to assess the extent of degeneration and rule out other conditions such as spinal stenosis or tumors. Treatment options may include physical therapy, pain management, and in some cases, surgical intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of spondylosis and related conditions.
  • Need for precise documentation of symptoms and imaging findings.
  • Potential overlap with inflammatory conditions like ankylosing spondylitis.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of neurological symptoms.
  • Failure to include imaging results in the medical record.
  • Misclassification of the condition as a more general spondylosis code.
  • Lack of clarity in the relationship between symptoms and the diagnosed condition.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic neck pain, stiffness, and neurological symptoms.

Billing Considerations

Orthopedic surgeons should document the extent of degeneration and any surgical interventions performed.

Neurology

Documentation Requirements

Comprehensive neurological assessments, including motor and sensory evaluations.

Common Clinical Scenarios

Patients with neurological deficits related to cervical spondylosis.

Billing Considerations

Neurologists must ensure that all neurological findings are clearly documented to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M47.891 When
  • According to ICD
  • 10 coding guidelines, M47
  • 891 should be used when the spondylosis is specifically located in the occipito
  • atlanto
  • axial region
  • Coders must ensure that the diagnosis is supported by appropriate clinical documentation and imaging studies

Exclusion Criteria

Do NOT use M47.891 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63030CPT Code

Laminectomy, cervical, for decompression of spinal cord

Clinical Scenario

Used in cases where spondylosis leads to significant spinal cord compression.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

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 M47.891, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M47.891, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 are the common symptoms associated with M47.891?

Common symptoms include neck pain, stiffness, headaches, and potential neurological deficits such as weakness or numbness in the arms.

How is M47.891 diagnosed?

Diagnosis is typically made through a combination of clinical evaluation, patient history, and imaging studies such as X-rays or MRI.

What treatment options are available for M47.891?

Treatment options may include physical therapy, pain management, and in some cases, surgical intervention if there is significant neurological involvement.