M43.0

M43.0: Spondylolysis

Non-billable headerICD-10-CM

M43.0 is a non-billable header ICD-10-CM code for spondylolysis. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital spondylolysis (Q76.2)
spondylolisthesis (M43.1)

Excludes1 inherited from the categories above M43.0

A category’s note binds every code beneath it.

Written on M43: Other deforming dorsopathies

congenital spondylolysis and spondylolisthesis (Q76.2)
hemivertebra (Q76.3-Q76.4)
Klippel-Feil syndrome (Q76.1)
lumbarization and sacralization (Q76.4)
platyspondylisis (Q76.4)
spina bifida occulta (Q76.0)
spinal curvature in osteoporosis (M80.-)
spinal curvature in Paget's disease of bone [osteitis deformans] (M88.-)

Other codes that can never be billed with M43.0

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

Q76.2Congenital spondylolisthesis

Risk adjustment

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

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead M43.0

10 child codes. Green means billable.