M48.16
M48.16: Ankylosing hyperostosis [Forestier], lumbar region
Billable / specific codeICD-10-CM
M48.16 is a billable, specific ICD-10-CM code for ankylosing hyperostosis [forestier], lumbar region. It is valid for submission on a claim.
Check M48.16 with the rest of the claim: free scrubberOther codes that can never be billed with M48.16
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
M48.16 is named in 27 Medicare coverage policies: 20 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
Alphabetic index entries that lead here
- Hyperostosis›ankylosing›lumbar region
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under M48.1
- M48.10Ankylosing hyperostosis [Forestier], site unspecified
- M48.11Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region
- M48.12Ankylosing hyperostosis [Forestier], cervical region
- M48.13Ankylosing hyperostosis [Forestier], cervicothoracic region
- M48.14Ankylosing hyperostosis [Forestier], thoracic region
- M48.15Ankylosing hyperostosis [Forestier], thoracolumbar region
- M48.17Ankylosing hyperostosis [Forestier], lumbosacral region
- M48.18Ankylosing hyperostosis [Forestier], sacral and sacrococcygeal region
- M48.19Ankylosing hyperostosis [Forestier], multiple sites in spine