ICD-10 Coding for Degeneration of Lumbar Intervertebral Disc(M51.360, M51.361, M51.362, M51.369)
Complete ICD-10-CM coding and documentation guide for Degeneration of Lumbar Intervertebral Disc. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degeneration of Lumbar Intervertebral Disc
M51.36-M51.369Primary Range
Degeneration of lumbar intervertebral disc codes
These codes specifically address the degeneration of lumbar intervertebral discs with varying symptoms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.360 | Lumbar disc degeneration with discogenic back pain only | Use when lumbar disc degeneration is confirmed with imaging and the patient has discogenic back pain without leg symptoms. |
|
| M51.361 | Lumbar disc degeneration with lower extremity pain only | Use when lumbar disc degeneration is confirmed with imaging and the patient has non-radicular leg pain. |
|
| M51.362 | Lumbar disc degeneration with both discogenic back pain and lower extremity pain | Use when both discogenic back pain and non-radicular leg pain are present and confirmed by imaging. |
|
| M51.369 | Lumbar disc degeneration without documented back/leg pain | Use when imaging shows disc degeneration but the patient is asymptomatic. |
|
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 disc degeneration
Essential facts and insights about Degeneration of Lumbar Intervertebral Disc
Primary ICD-10-CM Codes for degeneration of lumbar intervertebral disc
Decision Criteria
clinical Criteria
- MRI findings consistent with disc degeneration and back pain
Applicable To
- Discogenic back pain
Excludes
- Radiculopathy
- Sciatica
Clinical Validation Requirements
- MRI showing Pfirrmann grade III or higher
- Modic changes
- Annular tear
Code-Specific Risks
- Misidentifying radicular pain as discogenic
Coding Notes
- Ensure documentation specifies 'discogenic' to differentiate from other types of back pain.
M51.361 - Lumbar disc degeneration with lower extremity pain only
Use when lumbar disc degeneration is confirmed with imaging and the patient has non-radicular leg pain.
Applicable To
- Non-radicular lower extremity pain
Excludes
- Radiculopathy
- Sciatica
Clinical Validation Requirements
- MRI showing disc degeneration
- Pain pattern consistent with sclerotomal referral
Coding Notes
Document the non-radicular nature of the leg pain clearly.
M51.362 - Lumbar disc degeneration with both discogenic back pain and lower extremity pain
Use when both discogenic back pain and non-radicular leg pain are present and confirmed by imaging.
Applicable To
- Discogenic back pain with non-radicular leg pain
Excludes
- Radiculopathy
- Sciatica
Clinical Validation Requirements
- MRI showing disc degeneration
- Both back and leg pain documented as discogenic
Coding Notes
Ensure both types of pain are clearly documented as discogenic.
M51.369 - Lumbar disc degeneration without documented back/leg pain
Use when imaging shows disc degeneration but the patient is asymptomatic.
Applicable To
- Asymptomatic disc degeneration
Clinical Validation Requirements
- Imaging showing disc degeneration without pain symptoms
Coding Notes
Ensure lack of symptoms is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic pain syndrome
G89.29Differential 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 Degeneration of Lumbar Intervertebral Disc to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.360.
Impact
Clinical: Misleading clinical picture., Regulatory: Non-compliance with documentation standards., Financial: Potential denial of claims.
Mitigation Strategy
Ensure detailed documentation of pain origin., Include imaging findings.
Impact
Reimbursement: May lead to incorrect DRG assignment affecting reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Always specify whether the patient has back pain, leg pain, or both.
Impact
Failure to document symptoms linked to disc degeneration.
Mitigation Strategy
Implement thorough documentation practices.
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 Degeneration of Lumbar Intervertebral Disc, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degeneration of Lumbar Intervertebral Disc
Use these documentation templates to ensure complete and accurate documentation for Degeneration of Lumbar Intervertebral Disc. These templates include all required elements for proper coding and billing.
Chronic discogenic low back pain
Specialty: OrthopedicsRequired Elements
- Pain characterization
- Imaging findings
- Exclusion of radiculopathy
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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