ICD OA spine

[JoJuan]

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?

 

[Alicia Scott]

Great question. Let me look into this and ask some of our team members for their insight.

 

[Jo-Anne Sheehan CPC-I]

ICD-10 is designed to provide more specific diagnostic coding to allow more concise reporting of conditions and diseases. It is the physician’s responsibility to be comprehensive when defining a disease process or condition and reporting these findings. When a second organ system is involved as in the code M47.896, proper coding protocol must address with specificity not only the skeletal component but any neurological component as well, namely, radiculopathy or myelopathy. With regards to your diagnosis choice of M47.816: “Spondylosis, other lumbar region” is correct since, the Physician did not mention radiculopathy or myelopathy, but only OA. OA is a condition contained under both Spondylosis classifications.

- Dr. Thomas Sheehan

 

[Alicia Scott]

Thank you Dr. Sheehan for that information. Excellent point. Appreciate your feedback.

 

[JoJuan]

Thank you so much for the feedback!