ICD-10 Coding for Degenerative Spondylolisthesis(M43.16)
Complete ICD-10-CM coding and documentation guide for Degenerative Spondylolisthesis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Degenerative Spondylolisthesis
M43.1-M43.19Primary Range
Spondylolisthesis
This range includes codes for spondylolisthesis, specifying the spinal region affected.
Spinal stenosis
This range includes codes for spinal stenosis, often associated with degenerative spondylolisthesis.
Key Information: ICD-10 code for degenerative spondylolisthesis
Essential facts and insights about Degenerative Spondylolisthesis
Primary ICD-10-CM Code for degenerative spondylolisthesis
Decision Criteria
clinical Criteria
- Presence of neurogenic claudication symptoms
Applicable To
- Degenerative spondylolisthesis of the lumbar region
Excludes
- Congenital spondylolisthesis (Q76.2)
Clinical Validation Requirements
- Dynamic X-rays showing ≥3mm vertebral translation
- MRI showing facet degeneration
Code-Specific Risks
- Incorrectly using unspecified codes when the region is known
Coding Notes
- Ensure documentation specifies the lumbar region and degenerative nature.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Spinal stenosis, lumbar region
M48.06Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Spondylolisthesis, lumbosacral region
M43.17Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Degenerative Spondylolisthesis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M43.16.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential for claim denials.
Mitigation Strategy
Use templates that prompt for specific details., Regular training on documentation standards.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify the spinal region affected when known.
Impact
High risk of audits if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Implement regular audits of coding practices and provide feedback.
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 Spondylolisthesis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Spondylolisthesis
Use these documentation templates to ensure complete and accurate documentation for Degenerative Spondylolisthesis. These templates include all required elements for proper coding and billing.
Neurosurgery Evaluation
Specialty: NeurosurgeryRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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