ICD-10 Coding for Spinal Claudication(M48.062, M48.061)
Complete ICD-10-CM coding and documentation guide for Spinal Claudication. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Spinal Claudication
M48.06-M48.062Primary Range
Spinal stenosis, lumbar region with or without neurogenic claudication
This range covers lumbar spinal stenosis with specific emphasis on neurogenic claudication, which is the primary focus for coding and documentation.
Nerve root and plexus compressions in other dorsopathies
Used when there is documented nerve root compression associated with lumbar spinal stenosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M48.062 | Spinal stenosis, lumbar region with neurogenic claudication | Use when neurogenic claudication is confirmed with imaging and clinical symptoms. |
|
| M48.061 | Spinal stenosis, lumbar region without neurogenic claudication | Use when lumbar stenosis is present without neurogenic claudication symptoms. |
|
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 spinal claudication
Essential facts and insights about Spinal Claudication
Primary ICD-10-CM Codes for spinal claudication
Decision Criteria
clinical Criteria
- Presence of leg pain relieved by sitting and confirmed stenosis on MRI.
Applicable To
- Neurogenic claudication due to lumbar spinal stenosis
Excludes
- Vascular claudication (I73.9)
Clinical Validation Requirements
- Leg/buttock pain triggered by walking/standing
- Relief with sitting/spinal flexion
- MRI-confirmed central canal stenosis ≥10mm
Code-Specific Risks
- Incorrectly using M48.06 without specifying neurogenic claudication.
Coding Notes
- Ensure documentation specifies neurogenic claudication symptoms and imaging findings.
M48.061 - Spinal stenosis, lumbar region without neurogenic claudication
Use when lumbar stenosis is present without neurogenic claudication symptoms.
Applicable To
- Lumbar spinal stenosis without neurogenic symptoms
Excludes
- Neurogenic claudication (M48.062)
Clinical Validation Requirements
- Lumbar stenosis without neurogenic symptoms
Coding Notes
Ensure absence of neurogenic symptoms is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Nerve root and plexus compressions in other dorsopathies
G55.3Differential 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 Spinal Claudication to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M48.062.
Impact
Clinical: Inaccurate diagnosis representation., Regulatory: Potential audit issues., Financial: Claim denials due to insufficient documentation.
Mitigation Strategy
Use templates to ensure all details are captured., Regular training on documentation standards.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always specify neurogenic claudication when present and use M48.062.
Impact
Lack of detailed symptom documentation can trigger audits.
Mitigation Strategy
Ensure all neurogenic symptoms and imaging findings are documented.
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 Spinal Claudication, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Spinal Claudication
Use these documentation templates to ensure complete and accurate documentation for Spinal Claudication. These templates include all required elements for proper coding and billing.
Neurogenic claudication diagnosis
Specialty: NeurologyRequired Elements
- Patient history
- Physical exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Spinal Claudication? Ask your questions below.