M48.05
M48.05: Spinal stenosis, thoracolumbar region
Billable / specific codeICD-10-CM
M48.05 is a billable, specific ICD-10-CM code for spinal stenosis, thoracolumbar region. It is valid for submission on a claim.
Check M48.05 with the rest of the claim: free scrubberOther codes that can never be billed with M48.05
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G55Nerve root and plexus compressions in diseases classified elsewhere
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M48.05 is named in 26 Medicare coverage policies: 14 listing it as supporting medical necessity, and 12 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A57701Billing and Coding: Trigger Point Injections (TPI)not covered
- 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
Alphabetic index entries that lead here
- Stenosis, stenotic›spinal›thoracolumbar region
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under M48.0
- M48.00Spinal stenosis, site unspecified
- M48.01Spinal stenosis, occipito-atlanto-axial region
- M48.02Spinal stenosis, cervical region
- M48.03Spinal stenosis, cervicothoracic region
- M48.04Spinal stenosis, thoracic region
- M48.06Spinal stenosis, lumbar region
- M48.07Spinal stenosis, lumbosacral region
- M48.08Spinal stenosis, sacral and sacrococcygeal region