ICD-10 Coding for Cervicalgia with Radiculopathy(M50.121, M54.12)
Complete ICD-10-CM coding and documentation guide for Cervicalgia with Radiculopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cervicalgia with Radiculopathy
M50.1-M50.9Primary Range
Cervical disc disorders
Primary range for cervical disc disorders with radiculopathy.
Radiculopathy and Cervicalgia
Used when radiculopathy is present without a specific structural cause.
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 at C5-C6 level with radiculopathy | Use when MRI confirms disc herniation at C5-C6 causing radiculopathy. |
|
| M54.12 | Cervical radiculopathy | Use when radiculopathy is present without identifiable structural cause. |
|
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 cervicalgia with radiculopathy
Essential facts and insights about Cervicalgia with Radiculopathy
Primary ICD-10-CM Codes for cervicalgia with radiculopathy
Decision Criteria
clinical Criteria
- MRI evidence of disc herniation at C5-C6
documentation Criteria
- Detailed neurological exam findings
Applicable To
- C5-C6 disc herniation with radiculopathy
Excludes
Clinical Validation Requirements
- MRI showing C5-C6 disc herniation
- Neurological exam confirming C6 radiculopathy
Code-Specific Risks
- Incorrectly using M54.12 when disc disorder is present
Coding Notes
- Ensure MRI findings support the diagnosis of disc disorder.
M54.12 - Cervical radiculopathy
Use when radiculopathy is present without identifiable structural cause.
Applicable To
- Radiculopathy without structural cause
Excludes
- M50.1-
- M47.2-
Clinical Validation Requirements
- Clinical exam showing radicular pain pattern
- Negative imaging for structural causes
Coding Notes
Ensure no structural cause is documented before using.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cervicalgia with 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: Inaccurate diagnosis, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure MRI or CT findings are documented, Include detailed neurological exam
Impact
Reimbursement: Incorrect DRG assignment, potential underpayment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use M50.1- when MRI confirms disc disorder causing radiculopathy.
Impact
Using M54.12 when structural cause is present
Mitigation Strategy
Verify imaging results before coding
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 Cervicalgia with Radiculopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cervicalgia with Radiculopathy
Use these documentation templates to ensure complete and accurate documentation for Cervicalgia with Radiculopathy. These templates include all required elements for proper coding and billing.
Cervical radiculopathy due to disc herniation
Specialty: NeurologyRequired Elements
- Patient history
- Neurological exam
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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