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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

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

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 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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.