Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder

The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association’s Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), and professional organizations such as the American Medical Association (AMA). Because the information included in the Coding Clinic is considered an official resource is it important to pay attention to their publications.

Usually there isn’t much related specifically to chiropractic care, but the Quarter 3, 2018 Coding Clinic addressed the coding of lumbar spondylolisthesis with radiculopathy. There is no available combination code which identifies both conditions so it is necessary to code both the spondylolisthesis (M43.1-) AND the radiculopathy (M54.1-) according to the anatomic site. The AHA article specifically answered a question about coding L4-L5 spondylolisthesis with radiculopathy and their answer stated that you should NOT use use a code from category M51.1- “M51.1 Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy” because spondylolisthesis is not an intervertebral disc disorder. They stated:

“In spondylolisthesis, the bony vertebra slips. A disc disorder typically involves herniation or displacement of the interior disc.” – AHA Coding Clinic 2018; Volume 5 Issue 3

These definitions are now considered official and should be kept in mind when making a code selection (e.g., M51- intervertebral disc disorder codes).

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