ICD-10 Guide

M51.37

Name: ICD-10-CM Medical Diagnosis Codes
Creator: Centers for Medicare & Medicaid Services
License: https://www.cms.gov/medicare/coding/icd10

Non-billable

Other intervertebral disc degeneration, lumbosacral region

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED08/28/2025

Code Description

ICD-10 M51.37 is a used to indicate a diagnosis of other intervertebral disc degeneration, lumbosacral region.

Key Diagnostic Point:

Other intervertebral disc degeneration, lumbosacral region

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

### ICD-10 Code Analysis: M51.37 - Other Intervertebral Disc Degeneration, Lumbosacral Region #### 1) Complexity Rating: Medium The complexity of coding M51.37 is rated as medium due to the need for precise documentation of the patient's condition, the potential for multiple underlying causes, and the requirement to differentiate from other related conditions. #### 2) Documentation Requirements - **Clinical Diagnosis**: A clear diagnosis of intervertebral disc degeneration must be documented in the medical record. - **Location**: Specific mention of the lumbosacral region (L1-S1) is necessary. - **Symptoms**: Documentation of associated symptoms (e.g., pain, radiculopathy) and their severity. - **Imaging Studies**: Results from MRI or CT scans that confirm degeneration should be included. - **Treatment History**: Any prior treatments (e.g., physical therapy, medications) and their outcomes should be documented. - **Exclusion of Other Conditions**: Documentation should indicate that other potential causes of back pain or degeneration have been ruled out. #### 3) Clinical Considerations - **Age-Related Changes**: Degeneration often correlates with age; understanding the patient's age and history of spinal issues is crucial. - **Comorbidities**: Conditions such as obesity, osteoporosis, or previous spinal surgeries may complicate the clinical picture. - **Functional Impact**: Assessing how the degeneration affects the patient's daily activities and quality of life is important for treatment planning. - **Potential for Progression**: Monitoring for progression to more severe conditions, such as herniated discs or spinal stenosis, is essential. #### 4) Audit Risk Factors - **Inadequate Documentation**: Lack of detailed documentation may lead to denials during audits. - **Misdiagnosis**: Incorrectly coding for more severe conditions (e.g., herniated disc) when only degeneration is present can trigger audits. - **Failure to Update Codes**: Not updating codes based on the latest clinical findings or changes in the patient's condition can lead to compliance issues. - **Lack of Specificity**: Using a non-specific code when a more specific code is available can increase audit risk. #### 5) Coding Best Practices - **Use Specific Codes**: Always select the most specific code available to accurately reflect the patient's condition. - **Regular Training**: Ensure coding staff are trained on the latest ICD-10 updates and guidelines to maintain compliance. - **Thorough Documentation**: Encourage providers to document all relevant clinical information to support the diagnosis and coding. - **Review and Update**: Regularly review patient records to ensure that coding reflects current clinical status and treatment. - **Collaboration with Clinicians**: Foster communication between coders and healthcare providers to clarify any ambiguities in documentation. By adhering to these guidelines, healthcare professionals can ensure accurate coding for M51.37, thereby improving patient care and minimizing audit risks.

Specialty Focus

Medical Specialties

### Medical Specialties Related to ICD-10 Code M51.37 **ICD-10 Code:** M51.37 **Description:** Other intervertebral disc degeneration, lumbosacral region #### 1. Primary Specialty (with %) - **Orthopedic Surgery (40%)** - Orthopedic surgeons frequently manage conditions related to intervertebral disc degeneration, particularly in the lumbosacral region. They may perform surgical interventions such as discectomy or spinal fusion when conservative treatments fail. #### 2. Secondary Specialties - **Neurology (25%)** - Neurologists assess and treat neurological symptoms associated with disc degeneration, such as radiculopathy or myelopathy. - **Physical Medicine and Rehabilitation (PM&R) (20%)** - Physiatrists focus on rehabilitation and non-surgical management of disc degeneration, including physical therapy and pain management strategies. - **Pain Management (10%)** - Pain management specialists may provide interventions such as epidural steroid injections or other pain relief techniques for patients suffering from chronic pain due to disc degeneration. - **Rheumatology (5%)** - Rheumatologists may be involved in cases where degenerative disc disease is associated with systemic inflammatory conditions. #### 3. Documentation Requirements - **Patient History:** - Detailed history of symptoms (onset, duration, severity, and exacerbating factors). - Previous treatments and their outcomes. - **Physical Examination:** - Neurological examination findings (motor strength, reflexes, sensory deficits). - Range of motion assessment of the lumbar spine. - **Diagnostic Imaging:** - MRI or CT scans showing degeneration of the intervertebral discs. - Documentation of any associated findings (e.g., herniation, stenosis). - **Treatment Plan:** - Description of conservative management strategies (e.g., physical therapy, medications). - Surgical considerations if applicable, including indications for surgery. #### 4. Clinical Scenarios - **Scenario 1:** - A 55-year-old male presents with chronic lower back pain radiating to the left leg. MRI reveals degenerative changes at L4-L5 and L5-S1. The patient has failed conservative management, and surgical intervention is discussed. - **Scenario 2:** - A 45-year-old female with a history of chronic back pain presents with new-onset weakness in the right leg. Neurological examination shows diminished reflexes and sensory loss. MRI indicates significant disc degeneration with nerve root compression. - **Scenario 3:** - A 60-year-old male with a history of diabetes presents with persistent lower back pain and difficulty walking. Physical therapy has provided minimal relief. The physician documents the need for pain management interventions due to the impact on the patient's quality of life. #### 5. Specialty Considerations - **Orthopedic Considerations:** - Surgeons must evaluate the patient's overall health and comorbidities before considering surgical options. Preoperative imaging and assessments are crucial for surgical planning. - **Neurological Considerations:** - Neurologists should be aware of the potential for progressive neurological deficits and the need for timely intervention to prevent permanent damage. - **PM&R Considerations:** - Rehabilitation specialists should focus on functional outcomes and may employ multidisciplinary approaches, including occupational therapy and psychological support. - **Pain Management Considerations:** - Pain specialists must consider the patient's overall pain management strategy, including the risks and benefits of interventional procedures versus pharmacologic management. - **Rheumatology Considerations:** - In cases where disc degeneration is part of a broader rheumatologic condition, rheumatologists should coordinate care with orthopedic and pain management specialists to address both the degenerative and inflammatory components. ### Conclusion Understanding the implications of ICD-10 code M51.37 is essential for healthcare professionals involved in the diagnosis and management of intervertebral disc degeneration. Proper documentation, interdisciplinary collaboration, and tailored treatment plans are critical for optimizing patient outcomes.

Coding Guidelines

Inclusion Criteria

Use M51.37 When

CM Coding Guidelines for M51
Other Intervertebral Disc Degeneration, Lumbosacral Region
1) Inclusion Criteria
37 is used to classify conditions involving degeneration of intervertebral discs in the lumbosacral region that are not specified as herniated or bulging discs
This code encompasses various degenerative changes in the lumbar and sacral intervertebral discs, which may include:
Disc desiccation
Disc space narrowing
Annular tears not classified elsewhere

Exclusion Criteria

Do NOT use M51.37 When

2) Exclusion Notes
Using Excluded Codes: Incorrectly coding conditions that are explicitly excluded from M51

Related CPT Codes

### CPT Codes for ICD-10 M51.37 (Other Intervertebral Disc Degeneration, Lumbosacral Region) #### 1. Lab/Diagnostic Procedures - **MRI of the Lumbar Spine**: - **CPT Code**: 72148 - **Description**: Magnetic resonance imaging, lumbar spine; without contrast material. - **CT Scan of the Lumbar Spine**: - **CPT Code**: 72131 - **Description**: Computed tomography, lumbar spine; without contrast material. - **X-ray of the Lumbar Spine**: - **CPT Code**: 72080 - **Description**: Radiologic examination, lumbar spine; 2 or 3 views. #### 2. Treatment Procedures - **Epidural Steroid Injection**: - **CPT Code**: 62322 - **Description**: Injection, epidural, lumbar or sacral, single level. - **Facet Joint Injection**: - **CPT Code**: 64493 - **Description**: Injection, anesthetic agent, lumbar or sacral facet joint, single level. - **Physical Therapy**: - **CPT Code**: 97110 - **Description**: Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (15 minutes). - **Chiropractic Manipulation**: - **CPT Code**: 98940 - **Description**: Chiropractic manipulative treatment, spinal, 1-2 regions. #### 3. Follow-Up Codes - **Evaluation and Management (E/M) Codes**: - **CPT Code**: 99213 - **Description**: Established patient office visit, low to moderate complexity. - **Physical Medicine and Rehabilitation**: - **CPT Code**: 97001 - **Description**: Physical therapy evaluation. #### 4. Reimbursement Ranges - **MRI of the Lumbar Spine**: $800 - $2,000 - **CT Scan of the Lumbar Spine**: $500 - $1,500 - **X-ray of the Lumbar Spine**: $100 - $300 - **Epidural Steroid Injection**: $1,000 - $2,500 - **Facet Joint Injection**: $500 - $1,500 - **Physical Therapy**: $50 - $150 per session - **Chiropractic Manipulation**: $30 - $100 per session - **E/M Codes**: $75 - $250 depending on complexity. #### 5. Billing Notes - Ensure that all procedures are medically necessary and supported by documentation in the patient's medical record. - Use appropriate modifiers (e.g., modifier 50 for bilateral procedures) when applicable. - Verify insurance coverage for specific procedures, as reimbursement rates may vary by payer. - Document the patient's history, examination findings, and treatment plan thoroughly to support the medical necessity of the services rendered. - Follow local and national guidelines for coding and billing to avoid denials and ensure compliance. ### Conclusion When coding for ICD-10 M51.37, it is essential to select the appropriate CPT codes based on the diagnostic and treatment procedures performed. Accurate documentation and adherence to coding guidelines will facilitate proper reimbursement and ensure quality patient care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

ICD-10 Impact for M51.37 (Other Intervertebral Disc Degeneration, Lumbosacral Region)

The transition from ICD-9 to ICD-10 has significantly impacted the coding and classification of various medical conditions, including intervertebral disc degeneration. The specific code M51.37 represents "Other intervertebral disc degeneration, lumbosacral region." Below is a detailed analysis of the impact of this code across several dimensions.

1. Clinical Specificity vs ICD-9

ICD-9 vs ICD-10

ICD-10 Impact for M51.37 (Other Intervertebral Disc Degeneration, Lumbosacral Region) The transition from ICD-9 to ICD-10 has significantly impacted the coding and classification of various medical conditions, including intervertebral disc degeneration. The specific code M51.37 represents "Other intervertebral disc degeneration, lumbosacral region." Below is a detailed analysis of the impact of this code across several dimensions. 1. Clinical Specificity vs ICD-9 - Increased Specificity: ICD-10 offers a more granular classification system compared to ICD-9. The code M51.37 allows for the identification of specific types of intervertebral disc degeneration that may not have been distinctly coded in ICD-9. This specificity aids in better understanding the clinical presentation and management of patients with lumbosacral disc degeneration. - Enhanced Documentation: The detailed nature of ICD-10 codes encourages healthcare providers to document patient conditions more thoroughly, which can lead to improved patient care and tailored treatment plans. 2. Quality Measures - Improved Data Collection:...

Reimbursement & Billing Impact

Reimbursement Impact - Reimbursement Models: The transition to ICD-10 has led to changes in reimbursement models, with payers increasingly relying on the specificity of ICD-10 codes to determine reimbursement rates. M51.37 may influence reimbursement levels based on the complexity of the condition and the associated treatment protocols. - Denial Rates: The increased specificity can reduce claim denials related to coding errors, as payers have clearer information regarding the patient's diagnosis. This can lead to improved cash flow for healthcare providers.

Resources

Clinical References

No clinical reference resources available for this code.

Coding & Billing References

No coding and billing reference resources available for this code.

Frequently Asked Questions

# FAQs for ICD-10 M51.37: Other Intervertebral Disc Degeneration, Lumbosacral Region ### Q1: Is M51.37 a billable code? **A1:** Yes, M51.37 is a billable code. It is used to describe other intervertebral disc degeneration in the lumbosacral region and can be used for billing purposes when the condition is documented in the patient's medical record. ### Q2: What are the documentation requirements for using M51.37? **A2:** To use M51.37, the following documentation requirements must be met: - A clear diagnosis of intervertebral disc degeneration in the lumbosacral region must be documented by the healthcare provider. - The medical record should include details about the patient's symptoms, physical examination findings, and any imaging studies that support the diagnosis. - Documentation should specify that the degeneration is not classified as a herniated disc or other specific types of disc disorders. ### Q3: When should M51.37 be used versus alternative codes? **A3:** M51.37 should be used when the patient presents with degeneration of the intervertebral discs in the lumbosacral region that does not fit into more specific categories such as: - M51.36 (Other intervertebral disc degeneration, thoracic region) - M51.34 (Degeneration of lumbar or lumbosacral intervertebral disc) - M51.37 is appropriate when the degeneration is not associated with radiculopathy or other complications that would require a different code. ### Q4: What are common scenarios for using M51.37? **A4:** Common scenarios for using M51.37 include: - A patient presenting with chronic lower back pain attributed to degenerative changes in the lumbar intervertebral discs, confirmed by MRI findings. - A patient with a history of back pain who undergoes imaging that reveals disc degeneration without herniation or significant nerve root involvement. - A patient experiencing limited mobility and discomfort due to age-related disc degeneration in the lumbosacral region, with no acute exacerbation or other complicating factors. ### Q5: What resources can healthcare professionals refer to for more information on M51.37? **A5:** Healthcare professionals can refer to the following resources for more information on M51.37: - **ICD-10-CM Official Guidelines for Coding and Reporting**: This document provides comprehensive guidelines for the correct use of ICD-10 codes. - **American Academy of Professional Coders (AAPC)**: Offers training and resources on coding practices and updates. - **Centers for Medicare & Medicaid Services (CMS)**: Provides information on coding policies and updates relevant to ICD-10. - **American Medical Association (AMA)**: Publishes the Current Procedural Terminology (CPT) and other coding resources that may be helpful in conjunction with ICD-10 coding. These resources can help ensure accurate coding and compliance with current standards.

M51.37

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Specialty Focus

Medical Specialties

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related ICD-10 Codes

Related CPT Codes

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions

M51.37

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Specialty Focus

Medical Specialties

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related ICD-10 Codes

Related CPT Codes

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions