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ICD-10 Guide
ICD-10 CodesM47.895

M47.895

Billable

Other spondylosis, thoracolumbar region

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

Code Description

ICD-10 M47.895 is a billable code used to indicate a diagnosis of other spondylosis, thoracolumbar region.

Key Diagnostic Point:

M47.895 refers to other forms of spondylosis affecting the thoracolumbar region of the spine, which encompasses the lower thoracic and upper lumbar vertebrae. Spondylosis is a degenerative condition characterized by the wear and tear of the spinal discs and joints, leading to pain, stiffness, and reduced mobility. This condition can result from age-related changes, repetitive stress, or injury. Patients may present with symptoms such as localized back pain, radiating pain to the lower extremities, and neurological deficits if nerve roots are compressed. Other spondylotic changes may include osteophyte formation, disc herniation, and facet joint degeneration. It is important to differentiate this code from other specific types of spondylosis, such as ankylosing spondylitis, which is an inflammatory condition leading to fusion of the spine. Accurate diagnosis and coding are essential for appropriate management and treatment planning, as well as for reimbursement purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other spondylotic conditions like ankylosing spondylitis.
  • Need for detailed documentation of symptoms and imaging findings.
  • Variability in clinical presentation among patients.
  • Potential overlap with other diagnoses such as spinal stenosis.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to differentiate from other spondylotic conditions.
  • Lack of imaging studies to support the diagnosis.
  • Incorrect linkage of diagnosis to treatment procedures.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed physical examination findings, imaging results, 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 to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and patient history.

Common Clinical Scenarios

Patients with suspected inflammatory back pain or systemic symptoms.

Billing Considerations

Differentiate between inflammatory and degenerative spondylosis to avoid misdiagnosis.

Coding Guidelines

Inclusion Criteria

Use M47.895 When
  • According to ICD
  • 10 guidelines, M47
  • 895 should be used when the spondylosis is not specified as ankylosing or another specific type
  • Documentation must clearly indicate the thoracolumbar region involvement and any associated symptoms or complications

Exclusion Criteria

Do NOT use M47.895 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

72040CPT Code

Radiologic examination, spine, thoracic, and lumbar

Clinical Scenario

Used when imaging is performed to evaluate spondylosis.

Documentation Requirements

Include reason for imaging and findings.

Specialty Considerations

Orthopedic specialists should ensure imaging correlates with 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 spondylotic conditions, improving the accuracy of diagnoses and treatment plans. M47.895 provides a distinct code for other spondylosis, enhancing data collection and analysis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spondylotic conditions, improving the accuracy of diagnoses and treatment plans. M47.895 provides a distinct code for other spondylosis, enhancing data collection and analysis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of spondylotic conditions, improving the accuracy of diagnoses and treatment plans. M47.895 provides a distinct code for other spondylosis, enhancing data collection and analysis.

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 M47.895 and M45?

M47.895 refers to other forms of spondylosis without inflammatory characteristics, while M45 is specifically for ankylosing spondylitis, which is an inflammatory condition leading to spinal fusion.