ICD-10 Coding for Cervical Radiculopathy(M50.121, M54.12)
Complete ICD-10-CM coding and documentation guide for Cervical Radiculopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cervical Radiculopathy
M50.1-M50.9Primary Range
Cervical disc disorders
Primary range for cervical radiculopathy due to disc disorders.
Cervical spondylosis with radiculopathy
Used when radiculopathy is due to bony changes such as spondylosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M50.121 | Cervical disc disorder with radiculopathy, high cervical region | Use when MRI confirms disc herniation in the high cervical region causing radiculopathy. |
|
| M54.12 | Radiculopathy, cervical region | Use when radiculopathy is present without MRI evidence of disc involvement. |
|
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 cervical radiculopathy
Essential facts and insights about Cervical Radiculopathy
Primary ICD-10-CM Codes for cervical radiculopathy
Decision Criteria
clinical Criteria
- Presence of MRI-confirmed disc herniation with radicular symptoms
documentation Criteria
- Detailed documentation of radicular symptoms and imaging findings
Applicable To
- Cervical disc herniation with radiculopathy
Excludes
- Cervical spondylosis with radiculopathy (M47.22)
Clinical Validation Requirements
- MRI showing disc herniation compressing a specific nerve root
- EMG confirming nerve root irritation
Code-Specific Risks
- Incorrectly using for non-disc related radiculopathy
Coding Notes
- Ensure MRI findings correlate with clinical symptoms for accurate coding.
M54.12 - Radiculopathy, cervical region
Use when radiculopathy is present without MRI evidence of disc involvement.
Applicable To
- Cervical radiculopathy without specific disc involvement
Excludes
- Cervical disc disorder with radiculopathy (M50.1-)
Clinical Validation Requirements
- Clinical exam showing radicular pain and sensory loss
- Negative MRI for disc pathology
Coding Notes
Ensure clinical documentation supports the absence of disc pathology.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Cervical Radiculopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M50.121.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials due to insufficient documentation
Mitigation Strategy
Use specific terminology for symptoms, Correlate clinical findings with imaging results
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use M50.1- codes when MRI confirms disc involvement.
Impact
Using non-specific codes when more specific ones are applicable
Mitigation Strategy
Regular training on ICD-10 updates and documentation standards
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 Cervical Radiculopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cervical Radiculopathy
Use these documentation templates to ensure complete and accurate documentation for Cervical Radiculopathy. These templates include all required elements for proper coding and billing.
Cervical radiculopathy due to disc herniation
Specialty: NeurologyRequired Elements
- Subjective: Description of radicular pain
- Objective: Neurological exam findings
- Assessment: Diagnosis with specific nerve root
- Plan: Treatment strategy
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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