ICD-10 Coding for Ankylosing Spondylitis(M45.0, M45.6)
Complete ICD-10-CM coding and documentation guide for Ankylosing Spondylitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ankylosing Spondylitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M45.0 | Ankylosing spondylitis of multiple sites in spine | Use when ankylosing spondylitis affects multiple spinal regions. |
|
| M45.6 | Ankylosing spondylitis lumbar region | Use when ankylosing spondylitis is localized to the lumbar region. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for ankylosing spondylitis
Essential facts and insights about Ankylosing Spondylitis
Primary ICD-10-CM Codes for ankylosing spondylitis
Decision Criteria
clinical Criteria
- Radiographic evidence of sacroiliitis
documentation Criteria
- Specify multiple spinal regions affected
Applicable To
- Ankylosing spondylitis affecting multiple spinal regions
Excludes
- Juvenile ankylosing spondylitis (M08.1)
Clinical Validation Requirements
- Radiographic evidence of sacroiliitis
- HLA-B27 positive
- Chronic inflammatory back pain
Code-Specific Risks
- Ensure documentation specifies multiple spinal regions.
Coding Notes
- Ensure to document specific spinal regions affected.
M45.6 - Ankylosing spondylitis lumbar region
Use when ankylosing spondylitis is localized to the lumbar region.
Applicable To
- Ankylosing spondylitis affecting the lumbar spine
Excludes
- Juvenile ankylosing spondylitis (M08.1)
Clinical Validation Requirements
- MRI showing sacroiliitis
- HLA-B27 positive
- Elevated CRP/ESR
Coding Notes
Document lumbar involvement specifically.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute and subacute iridocyclitis
H20.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ankylosing Spondylitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M45.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Ensure lab results are included in the patient's record., Regularly review documentation for completeness.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases specificity and accuracy of clinical data.
Mitigation Strategy
Always specify the spinal region affected by using codes like M45.6 for lumbar involvement.
Impact
Using unspecified codes can lead to audit flags.
Mitigation Strategy
Ensure all codes are as specific as possible, using the full ICD-10 code set.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Ankylosing Spondylitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ankylosing Spondylitis
Use these documentation templates to ensure complete and accurate documentation for Ankylosing Spondylitis. These templates include all required elements for proper coding and billing.
Rheumatology Progress Note
Specialty: RheumatologyRequired Elements
- Patient history
- Physical examination findings
- Imaging and lab results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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