M47.816: Spondylosis without myelopathy or radiculopathy, lumbar region
Billable ICD-10-CM code, FY2027
What M47.816 covers
M47.816 is for degenerative change of the lumbar spine, often called lumbar osteoarthritis or facet arthropathy, when there is no myelopathy or radiculopathy. Spine, pain management, radiology and physical therapy practices use it.
Region is the main choice: M47.817 is lumbosacral, M47.815 thoracolumbar and M47.812 cervical. When spondylosis causes radiculopathy, the code moves to M47.2- (M47.26 for lumbar). With myelopathy it moves to M47.1-.
Billing and coding notes
M47.816 is for spondylosis without nerve root or spinal cord involvement. If the provider documents radiculopathy from the spondylosis, use M47.26 instead and do not add M54.16. Radiculopathy with spondylosis is an excludes1 at M54.1.
Choose the region from the levels in the note. Findings at L5-S1 usually point to M47.817 rather than M47.816. Low back pain from the spondylosis is part of the diagnosis and is not coded separately.
Related codes under M47.81
- M47.811 Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region
- M47.812 Spondylosis without myelopathy or radiculopathy, cervical region
- M47.813 Spondylosis without myelopathy or radiculopathy, cervicothoracic region
- M47.814 Spondylosis without myelopathy or radiculopathy, thoracic region
- M47.815 Spondylosis without myelopathy or radiculopathy, thoracolumbar region
- M47.817 Spondylosis without myelopathy or radiculopathy, lumbosacral region
- M47.818 Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region
- M47.819 Spondylosis without myelopathy or radiculopathy, site unspecified
Questions about M47.816
What is the difference between M47.816 and M47.817?
M47.816 is the lumbar region and M47.817 is the lumbosacral region. Use the one that matches the documented levels.
Can M47.816 and M54.16 be coded together?
No. If the spondylosis causes the radiculopathy, the combination code M47.26 applies. Radiculopathy with spondylosis is an excludes1 at M54.1.
ICD-10-CM in CloudMedico
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