ICD-10 Coding for Degenerative Disc Disease (Lumbar)(M51.36, M51.37)
Complete ICD-10-CM coding and documentation guide for Degenerative Disc Disease (Lumbar). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Disc Disease (Lumbar)
M51.3-M51.37Primary Range
Other intervertebral disc degeneration
This range includes codes for degenerative disc disease specifically affecting the lumbar and lumbosacral regions.
Low back pain
These codes are used to describe associated pain conditions that may accompany lumbar DDD.
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 imaging confirms degeneration in the lumbar region without lumbosacral involvement. |
|
| M51.37 | Other intervertebral disc degeneration, lumbosacral region | Use when imaging confirms degeneration in the lumbosacral region. |
|
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 disc disease lumbar
Essential facts and insights about Degenerative Disc Disease (Lumbar)
Primary ICD-10-CM Codes for degenerative disc disease lumbar
Decision Criteria
clinical Criteria
- Presence of lumbar disc degeneration on imaging
Applicable To
- Degeneration of lumbar intervertebral disc
Excludes
- Degeneration of lumbosacral intervertebral disc (M51.37)
Clinical Validation Requirements
- MRI showing disc desiccation and height loss at L4-L5
Code-Specific Risks
- Risk of using without imaging confirmation
Coding Notes
- Ensure imaging findings are documented to support the use of this code.
M51.37 - Other intervertebral disc degeneration, lumbosacral region
Use when imaging confirms degeneration in the lumbosacral region.
Applicable To
- Degeneration of lumbosacral intervertebral disc
Excludes
- Degeneration of lumbar intervertebral disc (M51.36)
Clinical Validation Requirements
- MRI showing disc degeneration at L5-S1
Coding Notes
Ensure imaging findings are documented to support the use of this code.
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.
Vertebrogenic low back pain
M54.51Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Degenerative Disc Disease (Lumbar) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.36.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Verify imaging results before coding.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure MRI or CT findings are documented before coding.
Impact
Lack of imaging confirmation for DDD codes.
Mitigation Strategy
Ensure all imaging studies are documented in the patient record.
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 Disc Disease (Lumbar), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Disc Disease (Lumbar)
Use these documentation templates to ensure complete and accurate documentation for Degenerative Disc Disease (Lumbar). These templates include all required elements for proper coding and billing.
Chronic low back pain with lumbar DDD
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Treatment history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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