ICD-10 Coding for Degenerative Changes of the Lumbar Spine(M51.36, M51.37)
Complete ICD-10-CM coding and documentation guide for Degenerative Changes of the Lumbar Spine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Changes of the Lumbar Spine
M51.3-M51.37Primary Range
Other intervertebral disc degeneration
This range covers lumbar and lumbosacral disc degeneration with specific codes for pain localization.
Dorsalgia
Includes codes for low back pain and radiculopathy, often used in conjunction with primary codes.
Spinal stenosis
Used for cases with concurrent spinal stenosis, often secondary to degenerative changes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.36 | Other intervertebral disc degeneration, lumbar region | Use when degeneration is confirmed in the lumbar region without specific lumbosacral involvement. |
|
| M51.37 | Other intervertebral disc degeneration, lumbosacral region | Use when degeneration is confirmed at the lumbosacral junction. |
|
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 degenerative changes lumbar spine
Essential facts and insights about Degenerative Changes of the Lumbar Spine
Primary ICD-10-CM Codes for degenerative changes lumbar spine
Decision Criteria
clinical Criteria
- Presence of lumbar disc degeneration on imaging
documentation Criteria
- Documentation of pain characteristics and location
Applicable To
- Lumbar disc degeneration with or without pain
Excludes
- Disc displacement (M51.2-)
Clinical Validation Requirements
- MRI showing disc height loss
- Pfirrmann grade degeneration
Code-Specific Risks
- Risk of undercoding if pain is not specified
Coding Notes
- Ensure to specify pain presence and location for accurate coding.
M51.37 - Other intervertebral disc degeneration, lumbosacral region
Use when degeneration is confirmed at the lumbosacral junction.
Applicable To
- Lumbosacral disc degeneration with or without pain
Excludes
- Disc displacement (M51.2-)
Clinical Validation Requirements
- MRI showing degeneration at L5-S1
- Pfirrmann grade degeneration
Coding Notes
Ensure to specify the exact location and pain characteristics.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Degenerative Changes of the Lumbar Spine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.36.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use standardized templates, Regular documentation audits
Impact
Reimbursement: May lead to claim denials or reduced payments, Compliance: Non-compliance with 2025 coding updates, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use M51.36 or M51.37 with appropriate pain specification
Impact
Failure to specify pain can lead to audit flags
Mitigation Strategy
Ensure all documentation includes detailed pain descriptions
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 Degenerative Changes of the Lumbar Spine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Changes of the Lumbar Spine
Use these documentation templates to ensure complete and accurate documentation for Degenerative Changes of the Lumbar Spine. These templates include all required elements for proper coding and billing.
Chronic lumbar disc degeneration
Specialty: OrthopedicsRequired Elements
- Imaging findings
- Pain characteristics
- Functional impact
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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