ICD-10 Coding for Lumbosacral Radiculopathy(M54.17, M47.27)
Complete ICD-10-CM coding and documentation guide for Lumbosacral Radiculopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumbosacral Radiculopathy
M54.1-M54.17Primary Range
Radiculopathy codes for different spinal regions
This range includes specific codes for radiculopathy affecting different parts of the spine, with M54.17 specifically for the lumbosacral region.
Spondylosis with radiculopathy
This range is used when spondylosis is present with radiculopathy, particularly in the lumbosacral region.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M54.17 | Radiculopathy, lumbosacral region | Use when radiculopathy is isolated to the lumbosacral region without underlying spondylosis. |
|
| M47.27 | Spondylosis with radiculopathy, lumbosacral region | Use when spondylosis is confirmed with radiculopathy in the lumbosacral region. |
|
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 lumbosacral radiculopathy
Essential facts and insights about Lumbosacral Radiculopathy
Primary ICD-10-CM Codes for lumbosacral radiculopathy
Decision Criteria
clinical Criteria
- Presence of lumbosacral radiculopathy symptoms with imaging confirmation
coding Criteria
- No spondylosis present
Applicable To
- Lumbosacral radiculopathy
Excludes
- Spondylosis with radiculopathy (M47.27)
Clinical Validation Requirements
- MRI or CT showing nerve root compression
- EMG correlation
Code-Specific Risks
- Incorrect use when spondylosis is present
Coding Notes
- Ensure documentation specifies radiculopathy with laterality and imaging confirmation.
M47.27 - Spondylosis with radiculopathy, lumbosacral region
Use when spondylosis is confirmed with radiculopathy in the lumbosacral region.
Applicable To
- Lumbosacral spondylosis with radiculopathy
Excludes
- Isolated radiculopathy without spondylosis (M54.17)
Clinical Validation Requirements
- X-ray or MRI confirming spondylosis
- Radicular symptoms present
Coding Notes
Document spondylosis with imaging and radicular symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sciatica, left side
M54.32Differential 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 Lumbosacral Radiculopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.17.
Impact
Clinical: Leads to misdiagnosis or incorrect treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include imaging results in documentation., Cross-check documentation before submission.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Document 'radicular pain in L5 dermatome' to support M54.17
Impact
High risk of audit if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Ensure all documentation supports the use of specific codes.
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 Lumbosacral Radiculopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumbosacral Radiculopathy
Use these documentation templates to ensure complete and accurate documentation for Lumbosacral Radiculopathy. These templates include all required elements for proper coding and billing.
Chronic lumbosacral pain with radiculopathy
Specialty: NeurologyRequired Elements
- Location and laterality
- Symptom description
- Neurological exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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