# Lumbar Disc Herniation and Lumbar Radiculopathy



## chaimz

Hello,

My doctor documents:

1) Lumbar Herniated disc
2) Lumbar Radiculopathy

The two codes that I chose were M51.26, M54.16.

I am questioning this for a combo code: M51.06 - Intervertebral disc disorders with myelopathy, lumbar region.  On icd10data.com, under the code's 
Approximate Synonyms, it says Herniation of lumbar disc w radiculopathy.

My concern with this is the actual description of the code - Intervertebral disc disorders with myelopathy, lumbar region.   "Intervertebral disc disorders" is less specific than "Lumbar Herniated Disc", and since the doctor was specific in documenting "Lumbar Herniated Disc", I believe that M51.06 combo code would be wrong.  As well, Radiculopathy refers to the root of the nerve, where as myelopathy refers to the actual spinal cord.

What are your thoughts?


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## sxcoder1

I would code M51.16


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## chaimz

sxcoder1 said:


> I would code M51.16



Makes sense.  Thank you


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## slund777@hotmail.com

You would code M51.16 and M51.26 as they need to know the disorder M51.16 does not specify displacement. Thats what I was told by my coding mentor.


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## sxcoder1

I disagree with adding M51.26.  If you follow the index, it leads to just the one code for all of it, M51.16.


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## AlanPechacek

Unfortunately, ICD-10 does not use the term "Herniation" for intervertebral disc disorders.   It uses "Displacement" instead.  If you look up "Hernia, herniated, herniation" in the Alphabetical Index, you will see that for "Herniated Intervertebral Cartilage or Disc (which also includes Nucleus Pulposus)," it says *See Displacement*, Intervertebral disc.  Therefore, "Displacement" equals/is the same as "Herniation/Herniated" disc.  Code Set M51 is for *Intervertebral* *disc* *disorders* *with* *Radiculopathy* and is less "specific" than M51.2, which is for *Intervertebral* *Disc* *Displacement* (i.e. Herniation) *with* *Radiculopathy*.  In essence this is a Combination/Manifestation code since it combines the underlying pathology (disc herniation/displacement) with the manifestation (radiculopathy).  Therefore, M51.26 is the most specific code since the physician only designated the Lumber Region, not the Lumbosacral disc (M51.27).  So write in your code book that disc displacement is the same as disc herniation.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com


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