M48.061 — Spinal stenosis, lumbar region without neurogenic claudication
M48.061 is a billable, specific ICD-10-CM code for spinal stenosis, lumbar region without neurogenic claudication. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Spinal stenosis, lumbar region NOS
Other codes that can never be billed with M48.061
These codes carry an Excludes1 note pointing at M48.061. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M48.061 alone.
- G55Nerve root and plexus compressions in diseases classified elsewhere
Risk adjustment
M48.061 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.
Medicare coverage
M48.061 is named in 34 Medicare coverage policies — 22 listing it as supporting medical necessity, and 12 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How M48.061 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M48.061.
- Stenosis, stenotic›spinal›lumbar region(NOS) (without neurogenic claudication)
Code history
M48.061 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share M48.06. If M48.061 is not quite right, the correct code is usually one of these.
Questions about M48.061
- Is M48.061 a billable ICD-10-CM code?
- Yes. M48.061 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M48.061 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Spondylopathies (M45-M49).