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M47.27
ICD-10-CM
Lumbosacral Spondylosis with Radiculopathy

Find information on Lumbosacral Spondylosis with Radiculopathy including clinical documentation, medical coding, ICD-10 codes, diagnosis codes, treatment options, and healthcare guidelines. Learn about symptoms, causes, and prognosis for Lumbosacral Spondylosis Radiculopathy. This resource provides relevant information for healthcare professionals, medical coders, and patients seeking to understand this lower back condition. Explore resources related to radicular pain, nerve root compression, spinal stenosis, and degenerative disc disease in the lumbosacral spine.

Also known as

Degenerative Disc Disease with Nerve Compression
Lumbosacral Osteoarthritis with Radiculopathy

Diagnosis Snapshot

Key Facts
  • Definition : Degenerative spine changes in the lower back causing nerve compression.
  • Clinical Signs : Low back pain, leg pain (sciatica), numbness, tingling, weakness.
  • Common Settings : Outpatient clinics, pain management centers, spine surgery centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M47.27 Coding
M47.816

Other spondylosis with radiculopathy

Spondylosis with radiculopathy of the lumbosacral region.

M54.1

Radiculopathy, lumbosacral region

Pinched nerve causing pain in the lower back and legs.

M47.89

Other spondylosis, unspecified region

Spondylosis in a location not otherwise specified.

M51.2

Lumbosacral spondylosis without myelopathy

Degenerative changes in the lumbar and sacral spine.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is there radiculopathy?

  • Yes

    Dominant site: Lumbar?

  • No

    Code lumbosacral spondylosis only (M47.89).

Code Comparison

Related Codes Comparison

When to use each related code

Description
Lumbosacral spondylosis with radiculopathy
Lumbosacral spondylosis without radiculopathy
Lumbar spinal stenosis

Documentation Best Practices

Documentation Checklist
  • Lumbosacral spondylosis ICD-10 code M47.816
  • Radiculopathy ICD-10 code M54.1
  • Document nerve root affected (e.g., L5, S1)
  • Specific symptoms (pain, numbness, weakness)
  • Physical exam findings (e.g., SLR positive)

Coding and Audit Risks

Common Risks
  • Code Specificity

    Using unspecified codes (e.g., M47.9, M54.9) when more specific lumbosacral spondylosis with radiculopathy codes are justified based on documentation.

  • Radiculopathy Laterality

    Failing to code the affected side (right, left, bilateral) for the radiculopathy diagnosis, impacting reimbursement and data accuracy.

  • Causality Documentation

    Insufficient documentation linking the lumbosacral spondylosis to the radiculopathy symptoms, leading to coding and billing errors.

Mitigation Tips

Best Practices
  • Document radicular pain, sensory loss, or weakness for accurate ICD-10 coding (M47.2).
  • CDI: Specify nerve root affected & laterality for M54.1 codes. Avoid unspecified diagnoses.
  • HCC coding: Capture associated myelopathy for accurate RAF scores & risk adjustment.
  • Comply with MACRA by documenting functional limitations & treatment plan progress.
  • Regular neuro exams, imaging studies, and clear documentation support medical necessity.

Clinical Decision Support

Checklist
  • Verify low back pain radiating to leg(s): ICD-10 M47.2, M54.1
  • Confirm neurological signs (sensory/motor/reflex changes): Radiculopathy documentation
  • Imaging (MRI/CT) evidence of nerve root compression: Document findings & location
  • Correlate symptoms with imaging findings for accurate diagnosis: Patient safety priority
  • Exclude other causes of radiculopathy (e.g., disc herniation): Differential diagnosis

Reimbursement and Quality Metrics

Impact Summary
  • Lumbosacral Spondylosis with Radiculopathy reimbursement hinges on accurate ICD-10 coding (M47.x), CPT coding for procedures (e.g., imaging, injections, surgery), and modifier usage. Impacts:
  • Coding accuracy directly impacts claim denials, affecting revenue cycle and reimbursement rates.
  • Precise coding drives appropriate DRG assignment for inpatient cases, impacting hospital reimbursement.
  • Quality reporting metrics, including patient outcomes and pain management, are tied to accurate diagnosis coding and subsequent care.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code M47.26, M54.1x
  • Verify laterality: right, left
  • Document radicular pain
  • Confirm nerve root affected
  • Specify spondylosis level

Documentation Templates

Patient presents with complaints of lumbosacral pain radiating to the lower extremity, consistent with lumbosacral radiculopathy.  Symptoms include lower back pain, sciatica, leg pain, numbness, tingling, and weakness.  Onset of symptoms was gradual, reported as [duration and precipitating factors, if any].  Physical examination reveals [positive findings e.g., positive straight leg raise test, decreased reflexes, sensory deficits, muscle weakness] in the [affected dermatome/myotome, e.g., L5-S1 distribution].  Imaging studies, including [specify imaging modality, e.g., lumbar MRI, CT scan], demonstrate degenerative changes consistent with lumbosacral spondylosis, including [specific findings, e.g., disc herniation, osteophyte formation, spinal stenosis] at [spinal level, e.g., L4-L5, L5-S1].  Differential diagnoses considered include lumbar strain, herniated disc, spinal stenosis, piriformis syndrome, and facet joint syndrome.  Assessment: Lumbosacral spondylosis with radiculopathy.  Plan:  Conservative management initiated, including [specify treatment plan, e.g., physical therapy, NSAIDs, muscle relaxants].  Patient education provided on proper body mechanics, activity modification, and pain management strategies.  Follow-up scheduled in [timeframe] to assess response to treatment.  Further interventions, including [mention potential future interventions, e.g., epidural steroid injections, surgical consultation], will be considered if symptoms do not improve with conservative measures.  ICD-10 code: M47.816 (Other spondylosis with radiculopathy, lumbosacral region).