ICD-10 Coding for Degenerative Disc Disease of the Lumbar Spine(M51.36-, M51.37-)
Complete ICD-10-CM coding and documentation guide for Degenerative Disc Disease 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 Disc Disease of the Lumbar Spine
M51.36-M51.37Primary Range
Other intervertebral disc degeneration, lumbar and lumbosacral regions
These codes are used to specify degenerative disc disease in the lumbar and lumbosacral regions, with specific codes for pain localization.
Low back pain and other dorsalgia
These codes are used for general back pain when discogenic origin is not confirmed.
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 lumbar disc degeneration is confirmed with specific pain localization. |
|
| M51.37- | Other intervertebral disc degeneration, lumbosacral region | Use for degeneration at L5-S1 with confirmed discogenic pain. |
|
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 degenerative disc disease
Essential facts and insights about Degenerative Disc Disease of the Lumbar Spine
Primary ICD-10-CM Codes for degenerative disc lumbar
Decision Criteria
clinical Criteria
- Disc degeneration confirmed by imaging
documentation Criteria
- Pain localization documented
Applicable To
- Discogenic pain with specified localization
Excludes
- M54.5- (vertebrogenic pain)
Clinical Validation Requirements
- MRI showing disc degeneration
- Provocative discography with concordant pain
Code-Specific Risks
- Misuse with non-discogenic pain
Coding Notes
- Ensure documentation specifies pain location and confirms discogenic origin.
M51.37- - Other intervertebral disc degeneration, lumbosacral region
Use for degeneration at L5-S1 with confirmed discogenic pain.
Applicable To
- Discogenic pain at L5-S1
Excludes
- M54.5- (vertebrogenic pain)
Clinical Validation Requirements
- Discography with pain reproduction at L5-S1
Coding Notes
Documentation must confirm L5-S1 involvement and pain localization.
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 Disc Disease 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: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims
Mitigation Strategy
Use detailed templates, Educate clinicians on documentation standards
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on discogenic pain prevalence.
Mitigation Strategy
Use M51.36- with appropriate 6th character for confirmed discogenic pain.
Impact
Using general back pain codes instead of specific discogenic codes.
Mitigation Strategy
Educate staff on new coding requirements and ensure thorough documentation.
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 of the Lumbar Spine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Disc Disease of the Lumbar Spine
Use these documentation templates to ensure complete and accurate documentation for Degenerative Disc Disease of the Lumbar Spine. These templates include all required elements for proper coding and billing.
Chronic lumbar discogenic pain
Specialty: OrthopedicsRequired Elements
- Pain location
- Aggravating factors
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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