Is M51.36 a billable ICD-10-CM code?

No. M51.36 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M51.36 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other dorsopathies (M50-M54).

M51.36

M51.36 — Other intervertebral disc degeneration, lumbar region

Non-billable headerICD-10-CM

M51.36 is a non-billable header ICD-10-CM code for other intervertebral disc degeneration, lumbar region. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2 inherited from the categories above M51.36

Also inherited, and the opposite of Excludes1: these conditions are not part of M51.36, but a patient can have both, so you may code both.

Written on M51 — Thoracic, thoracolumbar, and lumbosacral intervertebral disc disorders

cervical and cervicothoracic disc disorders (M50.-)
sacral and sacrococcygeal disorders (M53.3)

Other codes that can never be billed with M51.36

These codes carry an Excludes1 note pointing at M51.36. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M51.36 alone.

M54.3Sciatica
M54.4Lumbago with sciatica
M54.5Low back pain
M54.6Pain in thoracic spine
S23.0Traumatic rupture of thoracic intervertebral disc
S23.0XXATraumatic rupture of thoracic intervertebral disc, initial encounter
S23.0XXDTraumatic rupture of thoracic intervertebral disc, subsequent encounter
S23.0XXSTraumatic rupture of thoracic intervertebral disc, sequela

Risk adjustment

M51.36 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 history

What changed, and when. Derived by diffing consecutive CMS release files — which matters when you are defending a code assigned under an earlier edition.

deletedFY2024-FY2026
Other intervertebral disc degeneration, lumbar region

Code to one of these instead M51.36

4 child codes. Green means billable.

Related codes at this level

Codes that share M51.3. If M51.36 is not quite right, the correct code is usually one of these.

Questions about M51.36

Is M51.36 a billable ICD-10-CM code?: No. M51.36 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M51.36 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other dorsopathies (M50-M54).