Is M43.2 a billable ICD-10-CM code?

No. M43.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M43.2 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Deforming dorsopathies (M40-M43).

What cannot be coded together with M43.2?

M43.2 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M43.2 (M43) and apply to it just the same.

M43.2

M43.2 — Fusion of spine

Non-billable headerICD-10-CM

M43.2 is a non-billable header ICD-10-CM code for fusion of spine. 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.

ankylosing spondylitis (M45.0-)
congenital fusion of spine (Q76.4)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

arthrodesis status (Z98.1)
pseudoarthrosis after fusion or arthrodesis (M96.0)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Ankylosis of spinal joint

Excludes1 inherited from the categories above M43.2

These are not written on M43.2, but they bind it: a note on a category applies to every code beneath it. Billing M43.2 with anything listed here is a denial.

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.-)

Risk adjustment

M43.2 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

M43.2 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead M43.2

9 child codes. Green means billable.

Related codes at this level

Codes that share M43. If M43.2 is not quite right, the correct code is usually one of these.

Questions about M43.2

Is M43.2 a billable ICD-10-CM code?: No. M43.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M43.2 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Deforming dorsopathies (M40-M43).
What cannot be coded together with M43.2?: M43.2 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M43.2 (M43) and apply to it just the same.