ICD-10 Coding for Herniated Disc Lumbar(M51.16, M51.06)
Complete ICD-10-CM coding and documentation guide for Herniated Disc Lumbar. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herniated Disc Lumbar
M51.0-M51.9Primary Range
Other intervertebral disc disorders
This range includes specific codes for lumbar disc herniation with various complications such as radiculopathy and myelopathy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region | Use when imaging confirms lumbar disc herniation with radiculopathy symptoms. |
|
| M51.06 | Intervertebral disc disorders with myelopathy, lumbar region | Use when imaging confirms lumbar disc herniation with myelopathy. |
|
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 herniated disc with radiculopathy
Essential facts and insights about Herniated Disc Lumbar
Primary ICD-10-CM Codes for herniated disc lumbar
Decision Criteria
clinical Criteria
- Presence of radiculopathy symptoms and imaging confirmation
documentation Criteria
- Detailed description of symptoms and imaging findings
Applicable To
- Lumbar disc herniation with radiculopathy
Clinical Validation Requirements
- MRI or CT showing lumbar disc herniation with nerve root compression
- Clinical signs of radiculopathy such as positive straight leg raise test
Code-Specific Risks
- Incorrectly coding as M54.5 when radiculopathy is present
Coding Notes
- Ensure documentation specifies radiculopathy and correlates with imaging findings.
M51.06 - Intervertebral disc disorders with myelopathy, lumbar region
Use when imaging confirms lumbar disc herniation with myelopathy.
Applicable To
- Lumbar disc herniation with spinal cord compression
Excludes
- Cervical disc disorders (M50.-)
- Thoracic disc disorders (M51.2-)
Clinical Validation Requirements
- MRI showing spinal cord compression
- Clinical signs of myelopathy
Coding Notes
Ensure documentation specifies myelopathy and correlates with imaging findings.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Herniated Disc Lumbar to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.16.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit issues., Financial: Reduced reimbursement.
Mitigation Strategy
Use specific clinical terms, Correlate symptoms with imaging
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use M51.16 when radiculopathy is confirmed by imaging.
Impact
Failure to document specific findings leading to incorrect coding.
Mitigation Strategy
Ensure detailed documentation of symptoms and imaging.
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 Herniated Disc Lumbar, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herniated Disc Lumbar
Use these documentation templates to ensure complete and accurate documentation for Herniated Disc Lumbar. These templates include all required elements for proper coding and billing.
Lumbar disc herniation with radiculopathy
Specialty: OrthopedicsRequired Elements
- Patient symptoms
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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