ICD-10 Coding for Arthropathy of Lumbar Facet(M46.96, M47.86)
Complete ICD-10-CM coding and documentation guide for Arthropathy of Lumbar Facet. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arthropathy of Lumbar Facet
M46-M47Primary Range
Other inflammatory spondylopathies and spondylosis
This range includes codes for inflammatory and degenerative conditions affecting the spine, relevant for coding lumbar facet arthropathy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M46.96 | Unspecified inflammatory spondylopathy, lumbar region | Use when documentation states 'facet arthropathy' without further specification. |
|
| M47.86 | Spondylosis without myelopathy or radiculopathy, lumbar region | Use when documentation specifies degenerative changes in the facet joints. |
|
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 lumbar facet arthropathy
Essential facts and insights about Arthropathy of Lumbar Facet
Primary ICD-10-CM Codes for arthropathy of lumbar facet
Decision Criteria
clinical Criteria
- Facet arthropathy without specific degenerative or inflammatory findings
Applicable To
- Facet arthropathy without specified etiology
Excludes
- Degenerative spondylosis (M47.86)
Clinical Validation Requirements
- Documentation of 'facet arthropathy' without degenerative or specific inflammatory etiology
Code-Specific Risks
- Misclassification if degenerative changes are present but not documented
Coding Notes
- Ensure documentation does not specify degenerative changes before using M46.96.
M47.86 - Spondylosis without myelopathy or radiculopathy, lumbar region
Use when documentation specifies degenerative changes in the facet joints.
Applicable To
- Degenerative facet joint disease
Excludes
- Inflammatory spondylopathy (M46.96)
Clinical Validation Requirements
- Imaging showing degenerative changes such as osteophytes or disc space narrowing
Coding Notes
Ensure degenerative changes are documented before using M47.86.
Differential 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 Arthropathy of Lumbar Facet to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M46.96.
Impact
Clinical: Misdiagnosis or inappropriate treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential for claim denials
Mitigation Strategy
Encourage detailed documentation of pain location and characteristics
Impact
Reimbursement: Potential claim denials due to incorrect coding, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Verify imaging or clinical documentation for degenerative changes before coding.
Impact
Lack of imaging evidence for facet arthropathy coding
Mitigation Strategy
Ensure imaging results are included in the patient's record
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 Arthropathy of Lumbar Facet, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthropathy of Lumbar Facet
Use these documentation templates to ensure complete and accurate documentation for Arthropathy of Lumbar Facet. These templates include all required elements for proper coding and billing.
Facet Arthropathy Diagnosis
Specialty: OrthopedicsRequired Elements
- Subjective pain description
- Objective physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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