Orthopedic Coding Alert

Abandon the mysterious “mid-cervical” term for more specific options.

After October 1, ICD-10-CM will revise the way you report cervical disc disorders and takes away the mystery of what “mid-cervical” actually means. Instead, you will have to identify the C4-C7 level, meaning the physician needs to document this information.

“This is a simply an expansion for greater specificity,” says Heidi Stout, BA, CPC, COSC, PCS, CCS-P, Coder on Call, Inc., Milltown, New Jersey. “Current code M50.02 (Cervical disc disorder with myelopathy, mid-cervical region) captures the C4-5, C5-6, and C6-7 levels, and as of October, we’ll have individual codes to specify each level.” The four new options are:

• M50.020 — Cervical disc disorder with myelopathy, mid-cervical region, unspecified level
• M50.021 — Cervical disc disorder at C4-C5 level with myelopathy
• M50.022 — Cervical disc disorder at C5-C6 level with myelopathy
• M50.023 — Cervical disc disorder at C6-C7 level with myelopathy.

Similarly, you should delete M50.12 (Cervical disc disorder with radiculopathy, mid-cervical region) and add the following four options:

• M50.120 — Mid-cervical disc disorder, unspecified
• M50.121 — Cervical disc disorder at C4-C5 level with radiculopathy
• M50.122 — Cervical disc disorder at C5-C6 level with radiculopathy
• M50.123 — Cervical disc disorder at C6-C7 level with radiculopathy.

Strike through M50.22 (Other cervical disc displacement, mid-cervical region), and look to these more specific codes:

• M50.220 — Other cervical disc displacement, mid-cervical region, unspecified level
• M50.221 — Other cervical disc displacement at C4-C5 level
• M50.222 — Other cervical disc displacement at C5-C6 level
• M50.223 — Other cervical disc displacement at C6-C7 level.

Again, you won’t need M50.32 (Other cervical disc degeneration, mid-cervical region). Instead, you will use:

• M50.320 — Other cervical disc degeneration, mid-cervical region, unspecified level
• M50.321 — Other cervical disc degeneration at C4-C5 level
• M50.322 — Other cervical disc degeneration at C5-C6 level
• M50.323 — Other cervical disc degeneration at C6-C7 level.

You can also forget M50.82 (Other cervical disc disorders, mid-cervical region), and use these diagnoses:

• M50.820 — Other cervical disc disorders, mid-cervical region, unspecified level
• M50.821 — Other cervical disc disorders at C4-C5 level
• M50.822 — Other cervical disc disorders at C5-C6 level
• M50.823 — Other cervical disc disorders at C6-C7 level.

Finally, as of October 1, you will stop using M50.92 (Cervical disc disorder, unspecified, mid-cervical region), and go for these codes instead:

• M50.920 — Unspecified cervical disc disorder, mid-cervical region, unspecified level
• M50.921 — Unspecified cervical disc disorder at C4-C5 level
• M50.922 — Unspecified cervical disc disorder at C5-C6 level
• M50.923 — Unspecified cervical disc disorder at C6-C7 level.

Important: Remember, you should avoid the unspecified code whenever possible. Your physicians should document to the highest specificity, which includes the cervical level.

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