Wiki NEW DX CODES M51.36-, M51.37-

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SLipp

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Hello, does anyone have any insight to the newly expanded (10/1/24) diagnosis codes M51.36 and M51.37? They have expanded the descriptions - Other intervertebral disc degeneration, lumbar (or lumboscaral for M51.37-)with;

M51.360 - with discogenic back pain only,
M51.361 - with lower extremity pain
M51.362 - with discogenic back pain and lower ext. pain
M51..369 without mention of lumbar back pain or lower extremity pain.

There was an article posted on Codify, published 9/4/24 - Prepared for Radiology Coding Changes With the 2024 ICD-10-CM Release. The article states "Healthcare providers who diagnose patients with intervertebral disc degeneration starting Oct.1, 2024, will have more options for detailing any additional pain the patient is experiencing. If the physician diagnoses the patient with discogenic back pain, lower extremity pain, a combination of the two, or disc degeneration without mention of pain, you'll assign one of the following codes for the lumbar region, coded under M51.36"

Our radiologists do not include the pain in the final impression. They will state DDD, disc disease, or disc degeneration. We would have to link the existence of pain back to the patient complaint or the referring physician orders. Also, we do not see the terms discogenic in the complaint or impression.

Any advice?

Thank you, Stacey
 
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SLipp said:
Hello, does anyone have any insight to the newly expanded (10/1/24) diagnosis codes M51.36 and M51.37? They have expanded the descriptions - Other intervertebral disc degeneration, lumbar (or lumboscaral for M51.37-)with;

M51.360 - with discogenic back pain only,
M51.361 - with lower extremity pain
M51.362 - with discogenic back pain and lower ext. pain
M51..369 without mention of lumbar back pain or lower extremity pain.

There was an article posted on Codify, published 9/4/24 - Prepared for Radiology Coding Changes With the 2024 ICD-10-CM Release. The article states "Healthcare providers who diagnose patients with intervertebral disc degeneration starting Oct.1, 2024, will have more options for detailing any additional pain the patient is experiencing. If the physician diagnoses the patient with discogenic back pain, lower extremity pain, a combination of the two, or disc degeneration without mention of pain, you'll assign one of the following codes for the lumbar region, coded under M51.36"

Our radiologists do not include the pain in the final impression. They will state DDD, disc disease, or disc degeneration. We would have to link the existence of pain back to the patient complaint or the referring physician orders. Also, we do not see the terms discogenic in the complaint or impression.

Any advice?

Thank you, Stacey
Click to expand...


If you would have previously coded M51.36 or M51.37 and your documentation doesn't give enough specificity on the pain to add the new 6th character 0,1, or 2, then I would suggest using M51.369/M51.379 which is the NOS code.
 
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sls314 said:
If you would have previously coded M51.36 or M51.37 and your documentation doesn't give enough specificity on the pain to add the new 6th character 0,1, or 2, then I would suggest using M51.369/M51.379 which is the NOS code.
Click to expand...

I should add that this reply was meant in general. The new default code is the one ending in 9 when there isn't enough specificity to add the 6th character of 0, 1, or 2.
 
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For M51.369 Does with "mention of" mean anywhere in the note or only in the assessment? For M51.361, m51.362 does there need to be a direct correlation between the back and leg pain in the assessment?

Subjective: Patient presents with chronic low back pain, right leg pain, and difficulty walking.

Assessment: 1. lumbar degenerative disc disease
2. spondylosis
3. spinal stenosis with neurogenic claudication
 
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