M41.116

M41.116: Juvenile idiopathic scoliosis, lumbar region

Billable / specific codeICD-10-CM

M41.116 is a billable, specific ICD-10-CM code for juvenile idiopathic scoliosis, lumbar region. It is valid for submission on a claim.

Check M41.116 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above M41.116

A category’s note binds every code beneath it.

Written on M41: Scoliosis

congenital scoliosis NOS (Q67.5)
congenital scoliosis due to bony malformation (Q76.3)
postural congenital scoliosis (Q67.5)
kyphoscoliotic heart disease (I27.1)

Excludes2 inherited from the categories above M41.116

Not part of this code, but both may be coded when both are present.

Written on M41: Scoliosis

postprocedural scoliosis (M96.89)
postradiation scoliosis (M96.5)

Other codes that can never be billed with M41.116

Their own Excludes1 notes name this code, so the conflict is not listed above.

M40Kyphosis and lordosis

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

M41.116 is named in 19 Medicare coverage policies: 12 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered