A. If the documentation is facet arthropathy the index must be followed and the correct code assignment will be M46. 96 Unspecified inflammatory spondylopathy, lumbar region.
The 2022 edition of ICD-10-CM M46. 96 became effective on October 1, 2021.
ICD-10-CM Code for Arthropathy, unspecified M12. 9.
92.
Lumbar facet arthropathy, also called facet joint arthritis or facet joint syndrome, refers to lower back pain caused by inflammation of the facet joints that connect one vertebra to another in the spine and the cartilage that lines them.
What is Lumbar Facet Joint Arthropathy? A joint is a place where two bones contact each other. Arthropathy means any disease of the joints. Lumbar facet joint arthropathy occurs when the facet joints degenerate or wear out over time due to aging or arthritis.
9: Dorsalgia, unspecified.
Code M25. 50 is the diagnosis code used for Pain in the Unspecified Joint. It falls under the category of Diseases of the musculoskeletal system and connective tissue.
ICD-10 code M51. 36 for Other intervertebral disc degeneration, lumbar region is a medical classification as listed by WHO under the range - Dorsopathies .
M53. 82 - Other specified dorsopathies, cervical region | ICD-10-CM.
5 – Low Back Pain. ICD-Code M54. 5 is a billable ICD-10 code used for healthcare diagnosis reimbursement of chronic low back pain.
Facet arthrosis often affects people who are older as the result of wear-and-tear on the facet joints. It can also be caused by: Arthritis of the facet joint. Repetitive stress on the joint. Osteoarthritis.
Unfortunately the GEMs mapping to ICD-10 for this code is M54.08 Panniculitis affecting region of neck and back, sacrococcygeal region. This is defined as inflammation of subcutaneous adipose tissue, which is not consistent with facet syndrome. This is a great example of how doctors who rely only on GEMs are headed for trouble. However, if the patient really has panniculitis, the this code is perfect.
The facet joints are a pair of joints in the posterior aspect of the spine. Their proper name is zygapophysial joints. These joints can become inflamed due to trauma or overuse and cause back pain. This is called facet syndrome. Unfortunately there was no ICD-9 code for this condition.
However, a patient may have an acute case of facet syndrome which does not include degeneration. And this code does not seem to address these acute cases. The moral of the story is to learn how to use the code book.
There is, unfortunately, still no ICD-10 code for facet syndrome. But, M53.8- other specified dorsopathies can be used just like the old ICD-9 code. It is the "other" code, which means it can be used for a specified condition like facet syndrome.
Facet joint arthropathy can occur anywhere in the spine and can have multiple causes, however, this article focuses on degenerative lumbar facet joint arthropathy.
CT is the best imaging modality for diagnosis and grading of the facet joints. On CT, joint space narrowing, subchondral sclerosis, erosions and osteophytes formations of the facet joints are noted. Gas can also be seen inside the joint representing the vacuum phenomenon.
The facet joints comprise the posterior elements of the "three-joint complex" (with the intervertebral disc forming the anterior element) that describes a spinal segment. Facet joint degeneration occurs as part of this complex, and as the disc degenerates more load will shift posteriorly and facet joint osteoarthritis will subsequently develop 6.
Patients can present with "facet joint syndrome" of low back pain radiating to the buttock, groin or thigh (o ften referred to as " pseudoradicular") but not below the knee. Symptoms can be unilateral or bilateral and there are no neurological deficits 7,8.
Radiography is not particularly sensitive for the detection of mild or moderate facet joint osteoarthritis and is best viewed as a screening tool 6. MRI and CT can both show morphological changes although MRI may underestimate severity 8. SPECT-CT is best at identifying patients with facetogenic low back pain who may benefit from facet joint injections 7.
History and diagnosis can suggest facet joint arthropathy as a cause for back pain. Facet joint injections may confirm facetogenic back pain but there are high false-positive rates 7,8. Some consider facet joint arthropathy as a cause for low back pain as a diagnosis of exclusion after discogenic causes and nerve root compression have been excluded 7.
It is a common finding in the human lumbar spine that increases in extent and severity over aging. About half of the adults younger than 30 years have some degrees of facet arthropathy. Men have a higher prevalence compared to women.
Most coders under or over code facet blocks because of the odd number of nerves to vertebra that occur in the cervical spine. Let's take a moment and review the spinal anatomy you'll need to know for correct code selection.
The facet joint is a synovial joint located between the superior articular process of one vertebra and the inferior articular process of the vertebra directly above it. Facet joints are also referred to as zygapophyseal joints and Z-joints, so watch for these alternative terms in the documentation.
A facet joint injection is a diagnostic procedure used to determine if the patient's spine pain is related to arthropathy of the facet joints. During a facet joint block, an anesthetic is injected into the facet joints where the associated spinal nerves travel to see if it will stop or 'block' the pain. Sometimes a steroid is injected with the anesthetic to help with the inflammation.
Each facet joint is innervated by two spinal nerves.
The next major issue with coding facet joint injections correctly is understanding the documentation. There is an industry standard way to document facet joint injections. When providers do not follow industry standard documentation practices over-coding or under-coding usually occurs.