Spinal stenosis lumbar region with neurogenic claudication icd 10

Spinal stenosis lumbar region with neurogenic claudication icd 10

October 19, 2017

Question:
I just received a claim denial because I used M48.06 (Spinal stenosis, lumbar region) as the diagnosis code. What’s the deal? I’ve been using this diagnosis code without a problem since ICD-10-CM started.

Answer:
Aha!  There are new diagnosis codes for lumbar stenosis that were effective October 1, 2017.  The code M48.06 is no longer a valid diagnosis code.  Instead, you’ll need to report one of the following 2 diagnosis codes:

M48.061, Spinal stenosis, lumbar region without neurogenic claudication

M48.062, Spinal stenosis, lumbar region with neurogenic claudication

Prior to 10/1/17, we did not have a single diagnosis code for lumbar stenosis with neurogenic claudication like we had in ICD-9-CM.  However, this changed on 10/1/17 and now there is a code for lumbar stenosis with neurogenic claudication.  The reason you experience the denial is because you used a code with 5 characters – M48.06 – which is now invalid.  The lumbar stenosis codes now require a 6th character to represent the presence (or not) of neurogenic claudication.

*This response is based on the best information available as of 10/19/17.

Spinal stenosis lumbar region with neurogenic claudication icd 10

Chapter 13 - Diseases of the musculoskeletal system and connective tissue (M00-M99) » Spondylopathies (M45-M49) » Spinal stenosis, lumbar region without neurogenic claudication (M48.061)

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Neurogenic claudication

Publication Date: September 2018

ICD 10 AM Edition: Tenth edition

Query Number: 3400

As there is no Index entry for neurogenic claudication can VICC please advise the correct code for neurogenic claudication secondary to central lumbar canal stenosis? We have queried several cases with a Neurosurgeon who has clarified that this term can be further described as nerve root compression.

If unable to obtain clarification from the clinician and if VICC cannot provide a default code, is it correct to code this to G95.8 Other specified diseases of spinal cord following Index entry:

Disease, diseased
- spinal (cord) G95.9
-- congenital Q06.9
-- specified NEC G95.8.

Response

For documentation of neurogenic claudication secondary to central lumbar canal stenosis where the clinician has clarified that the neurogenic claudication is nerve root compression, VICC considers it appropriate to follow Index entry Compression/nerve/root or plexus/with spinal (vertebra) stenosis or Stenosis/spinal/with nerve root compression to assign M48.06 Spinal stenosis, lumbar region and G55.3 Nerve root and plexus compressions in other dorsopathies.

As the term neurogenic means giving rise to or arising from the nervous system, in the absence of clinical clarification VICC considers the appropriate Index entry to follow for documentation of neurogenic claudication is Disease/nervous system to assign G98 Other disorders of nervous system, not elsewhere classified.

You may wish to send a public submission to ACCD for improvements to the Index.

Spinal stenosis lumbar region with neurogenic claudication icd 10
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What is Spinal stenosis, lumbar region with neurogenic claudication?

Neurogenic claudication is usually caused by spinal stenosis (narrowing of the spinal canal) in the lumbar spine (lower back). The narrowing of the spinal canal is generally caused by wear and tear and arthritic changes in the lower spine.

What is the difference between spinal stenosis and neurogenic claudication?

There are two types of claudication: neurogenic and vascular. Neurogenic claudication occurs because of narrowing in the spinal canal (stenosis) causing pressure on the spinal nerves. Vascular claudication results from blood flow that cannot match increased demand of muscles in oxygen during walking.

What is the ICD

ICD-10 code M48. 06 for Spinal stenosis, lumbar region is a medical classification as listed by WHO under the range - Dorsopathies .

What is Spinal stenosis, lumbar region without neurogenic claudication?

Lumbar spinal stenosis is a broad term referring to the symptoms which may result from the narrowing of the spinal canal in the lower back. This may be due to age, injury, or degeneration. Lumbar spinal stenosis occurs when the bony tunnels in the spine that transmit the spinal cord and nerve roots become narrowed.