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Q&A OA Spine ICD 10

J

JoJuan

Member
I have a question regarding coding of OA Spine (Spondylosis)for Icd 10. I am an auditor and have noticed some coders coding Lumbar spine OA M47.816 and some using M47.896. M47.816 is lumbar Spondylosis without myelopathy or radicuolopathy, I was under the impression that the provider should state without myelopathy or radiculopathy in order to use that code. So I have been using M47.896(other spondylosis lumbar region). I can't find any guidelines about coding this but I want to be sure the right code is being used. Is coding M47.816 correct for OA lumbar spine or should M47.896 be used?
 
P

Paul A

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You will need to query the physician and also to let them know they need to be more specific as there are more options in ICD-10. If its not documented properly you will be forced to use M47.896 or even worse if the region is not mentioned the default code M47.9

Some conditions the default code is the Without but in this case I don't see that you can select w/ or w/o unless its specified in the medical record
 
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