M42.16

M42.16: Adult osteochondrosis of spine, lumbar region

Billable / specific codeICD-10-CM

M42.16 is a billable, specific ICD-10-CM code for adult osteochondrosis of spine, lumbar region. It is valid for submission on a claim.

Check M42.16 with the rest of the claim: free scrubber

Other codes that can never be billed with M42.16

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

M40.0Postural kyphosis

Risk adjustment

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

Medicare coverage

M42.16 is named in 12 Medicare coverage policies: 5 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

M42.16: Adult osteochondrosis of spine, lumbar region

Other codes that can never be billed with M42.16

Risk adjustment

Medicare coverage

Alphabetic index entries that lead here

Code history

Other codes under M42.1