Patient presents with complaints of chronic back pain consistent with osteoarthritis of the spine.  Symptoms include localized pain, stiffness, and reduced range of motion.  The onset of pain is gradual and worsens with activity.  Pain may be described as aching, dull, or sharp.  Morning stiffness is common, typically lasting less than 30 minutes.  Physical examination reveals tenderness to palpation of the affected spinal segments, crepitus on movement, and possible muscle spasm.  Radiographic imaging, including X-rays of the lumbar andor thoracic spine, demonstrates osteophyte formation, joint space narrowing, and subchondral sclerosis, confirming the diagnosis of osteoarthritis.  Differential diagnoses considered include degenerative disc disease, spinal stenosis, and facet joint syndrome.  Treatment plan includes conservative management with nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, physical therapy to improve mobility and strengthen supporting muscles, and patient education on activity modification and proper body mechanics.  Referral to a pain specialist or orthopedist may be considered for further evaluation and management if symptoms persist or worsen despite conservative treatment.  ICD-10 code M47.816  Osteoarthritis, unspecified site, back and CPT codes for evaluation and management, physical therapy, and imaging as appropriate will be used for billing purposes.  Patient understands the diagnosis and treatment plan and agrees to follow-up care.