ICD-10 Coding for Cervical Spondylolisthesis(M43.12)
Complete ICD-10-CM coding and documentation guide for Cervical Spondylolisthesis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cervical Spondylolisthesis
Key Information: ICD-10 code for cervical spondylolisthesis
Essential facts and insights about Cervical Spondylolisthesis
Primary ICD-10-CM Code for cervical spondylolisthesis
Decision Criteria
clinical Criteria
- Imaging shows ≥3mm slippage in cervical vertebrae.
documentation Criteria
- Detailed imaging report confirming slippage.
Applicable To
- Cervical vertebral slippage
Excludes
- Spondylosis without slippage (M47.8-)
Clinical Validation Requirements
- Imaging confirms vertebral slippage (≥3mm on X-ray/MRI).
- Absence of neurological deficits unless specified with additional codes.
Code-Specific Risks
- Confusion with spondylosis codes.
- Missing documentation of slippage measurement.
Coding Notes
- Ensure imaging reports are reviewed to confirm slippage before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Cervicalgia
M54.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Cervical spondylosis without myelopathy or radiculopathy
M47.812Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cervical Spondylolisthesis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M43.12.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure imaging reports are included in patient records., Train staff on the importance of documenting slippage measurements.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Misclassification can result in compliance issues., Data Quality: Inaccurate data affects patient records and treatment plans.
Mitigation Strategy
Verify imaging reports for slippage before coding.
Impact
Risk of audits due to incorrect use of spondylosis codes instead of spondylolisthesis.
Mitigation Strategy
Regular training on differentiating between spondylolisthesis and spondylosis.
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 Spondylolisthesis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cervical Spondylolisthesis
Use these documentation templates to ensure complete and accurate documentation for Cervical Spondylolisthesis. These templates include all required elements for proper coding and billing.
Cervical spondylolisthesis with radiculopathy
Specialty: NeurosurgeryRequired Elements
- History of present illness
- Imaging review
- Physical exam findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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