ICD-10 Coding for Discogenic Disease(M54.51, M54.52)
Complete ICD-10-CM coding and documentation guide for Discogenic Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Discogenic Disease
M51-M54Primary Range
Other Dorsopathies
This range includes codes for disc disorders and dorsalgia, relevant for discogenic disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M54.51 | Vertebral endplate pain, lumbar region | Use when discogenic pain is confirmed with imaging and clinical findings. |
|
| M54.52 | Vertebral endplate pain with referred leg pain | Use when discogenic pain presents with referred leg pain but no radiculopathy. |
|
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 discogenic disease
Essential facts and insights about Discogenic Disease
Primary ICD-10-CM Codes for discogenic disease
Decision Criteria
clinical Criteria
- Presence of axial midline pain with imaging confirmation
Applicable To
- Discogenic low back pain
Excludes
- M54.50 (Unspecified low back pain)
Clinical Validation Requirements
- Axial midline lumbar pain
- Positive provocative discography
- MRI showing Modic changes
Code-Specific Risks
- Undercoding as M54.50 if discogenic origin is not specified.
Coding Notes
- Ensure documentation specifies discogenic origin to avoid unspecified coding.
M54.52 - Vertebral endplate pain with referred leg pain
Use when discogenic pain presents with referred leg pain but no radiculopathy.
Applicable To
- Discogenic pain with non-radicular leg pain
Excludes
- Radiculopathy (M54.1-)
Clinical Validation Requirements
- Lumbar pain with referred leg pain
- Negative for radicular symptoms
Coding Notes
Ensure leg pain is non-radicular to avoid incorrect coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other intervertebral disc degeneration, lumbar region
M51.36Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Discogenic Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.51.
Impact
Clinical: Inaccurate diagnosis coding., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure imaging is documented in the patient record.
Impact
Reimbursement: Potential underpayment due to unspecified coding., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Ensure documentation specifies discogenic origin to use M54.51.
Impact
Risk of using unspecified codes when specific codes are available.
Mitigation Strategy
Ensure documentation supports specific code use.
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 Discogenic Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Discogenic Disease
Use these documentation templates to ensure complete and accurate documentation for Discogenic Disease. These templates include all required elements for proper coding and billing.
Chronic lumbar discogenic pain
Specialty: NeurosurgeryRequired Elements
- Pain localization
- Imaging findings
- Provocative test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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