ICD-10 Coding for Lumbar Discogenic Disease(M51.360, M51.362)
Complete ICD-10-CM coding and documentation guide for Lumbar Discogenic Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumbar Discogenic Disease
M51.36-M51.37Primary Range
Other intervertebral disc degeneration, lumbar and lumbosacral regions
These codes specify the presence of back or leg pain associated with lumbar disc degeneration.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M51.360 | Discogenic back pain only | Use when chronic low back pain is confirmed by imaging and no leg pain is present. |
|
| M51.362 | Back + leg pain | Use when both back and non-radicular leg pain are present. |
|
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 discogenic disease
Essential facts and insights about Lumbar Discogenic Disease
Primary ICD-10-CM Codes for lumbar discogenic disease
Decision Criteria
clinical Criteria
- MRI confirmation of disc degeneration without leg symptoms
Applicable To
- Back pain due to lumbar disc degeneration
Excludes
- Radiculopathy
- Sciatica
Clinical Validation Requirements
- MRI showing Modic changes
- Absence of leg symptoms
- Failed conservative care ≥6 weeks
Code-Specific Risks
- Incorrectly coding as M54.5 when discogenic etiology is documented.
Coding Notes
- Ensure documentation specifies discogenic origin to avoid defaulting to M54.5.
M51.362 - Back + leg pain
Use when both back and non-radicular leg pain are present.
Applicable To
- Back and referred leg pain due to lumbar disc degeneration
Excludes
- Radiculopathy
- Sciatica
Clinical Validation Requirements
- Pain diagram showing sclerotomal pattern
- Discogram concordance
Coding Notes
Document the absence of radicular symptoms to justify use.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic pain syndrome
G89.29Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lumbar Discogenic Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M51.360.
Impact
Clinical: Inaccurate diagnosis representation., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always include MRI or discography results in notes., Use templates to ensure completeness.
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Upgrade to M51.36- when etiology is documented.
Impact
Using non-specific codes when specific codes are available.
Mitigation Strategy
Educate staff on new code updates and 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 Lumbar Discogenic Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumbar Discogenic Disease
Use these documentation templates to ensure complete and accurate documentation for Lumbar Discogenic Disease. These templates include all required elements for proper coding and billing.
Neurosurgery Consult
Specialty: NeurosurgeryRequired Elements
- Subjective pain history
- Objective exam findings
- Imaging results
- Discography results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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