M51.A3

M51.A3: Intervertebral annulus fibrosus defect, lumbosacral region, unspecified size

Billable / specific codeICD-10-CM

M51.A3 is a billable, specific ICD-10-CM code for intervertebral annulus fibrosus defect, lumbosacral region, unspecified size. It is valid for submission on a claim.

Check M51.A3 with the rest of the claim: free scrubber

Code first

The underlying condition must be sequenced before this code.

, if applicable, lumbosacral disc herniation (M51.17, M51.27)

Excludes2 inherited from the categories above M51.A3

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

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.A3

Their own Excludes1 notes name this code, so the conflict is not listed above.

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
S33Dislocation and sprain of joints and ligaments of lumbar spine and pelvis
S33.0Traumatic rupture of lumbar intervertebral disc
S33.0XXATraumatic rupture of lumbar intervertebral disc, initial encounter

Risk adjustment

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

Medicare coverage

M51.A3 is named in 8 Medicare coverage policies: 1 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