M43.8X7

M43.8X7: Other specified deforming dorsopathies, lumbosacral region

Billable / specific codeICD-10-CM

M43.8X7 is a billable, specific ICD-10-CM code for other specified deforming dorsopathies, lumbosacral region. It is valid for submission on a claim.

Check M43.8X7 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above M43.8X7

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.-)

Excludes2 inherited from the categories above M43.8X7

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

Written on M43.8: Other specified deforming dorsopathies

kyphosis and lordosis (M40.-)
scoliosis (M41.-)

Risk adjustment

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

Medicare coverage

M43.8X7 is named in 18 Medicare coverage policies: 11 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

Code history

Unchanged in every release from FY2024 to FY2027.